S&C QCOR ASC 2567s
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ASCs 2567s
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Time Interval

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Provider Characteristics

Use these filters if you want to limit the report to providers that have certain characteristics. To select more than one option, hold down the Ctrl (individual point-and-click) OR Shift keys (select through a range) while you click on the additional desired option(s).

Survey Type & Deficiency Tags

Use these filters if you want to limit the reports to providers on specific survey types, or to reports that were cited for specific ASC deficiency tags and tag types. To select more than one option, hold down the Ctrl (individual point-and-click) OR Shift keys (select through a range) while you click on the additional desired option(s).

CCN and Facility Name

Use these filters if you know the name (or partial name) of the facility you are searching for, or the CMS Certification Number (CCN) for the facility you are searching for.

Other Survey Characteristics

Select one of the options below to filter by surveys that cite deficiencies or by surveys that are deficiency-free. By default, only surveys that cite deficiencies are displayed. Selecting "All" displays all surveys.

CMS Certification Number Facility Name Address City State CMS Region Date of CMS Survey Survey Event ID Survey Type Statement of Deficiencies Report
▼ 05C0001149 Ocige Inc 26732 Crown Valley Pkwy Mission Viejo CA 9 (San Francisco) 02/13/2020 K1XC11 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0061 ANESTHETIC RISK AND EVALUATION Standard
Q0064 STANDARD LEVEL TAG FOR SURGICAL SERVICES Standard
Q0082 PROGRAM DATA; PROGRAM ACTIVITIES Standard
Q0101 PHYSICAL ENVIRONMENT Standard
Q0109 EMERGENCY EQUIPMENT Standard
Q0122 REAPPRAISALS Standard
Q0141 ORGANIZATION AND STAFFING Standard
Q0162 FORM AND CONTENT OF RECORD Standard
Q0181 ADMINISTRATION OF DRUGS Standard
Q0241 SANITARY ENVIRONMENT Standard
Q0242 INFECTION CONTROL PROGRAM Standard
Q0243 INFECTION CONTROL PROGRAM - DIRECTION Standard
Q0244 INFECTION CONTROL PROGRAM - QAPI Standard
Q0261 PATIENT ASSESSMENT AND ADMISSION Standard
Q0265 DISCHARGE - SUPPLIES AND INFORMATION Standard
▼ 05C0001175 San Leandro Surgery Center Ltd A California Limited Partnership 15035 East 14th Street San Leandro CA 9 (San Francisco) 06/13/2018 PY9Z21 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
E0004 Develop EP Plan, Review and Update Annually Standard
E0013 Development of EP Policies and Procedures Standard
E0029 Development of Communication Plan Standard
E0036 EP Training and Testing Standard
K0233 Clear Width of Exit and Exit Access Doors Standard
K0291 Emergency Lighting Standard
K0341 Fire Alarm System - Installation Standard
K0345 Fire Alarm System - Testing and Maintenance Standard
K0353 Sprinkler System - Maintenance and Testing Standard
K0372 Subdivision of Building Spaces ? Smoke Barrier Construction Standard
K0511 Utilities - Gas and Electric Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
▼ 05C0001178 La Veta Surgical Center 681 S Parker St, Suite 150 Orange CA 9 (San Francisco) 05/29/2019 BCYY11 Complaint, Sample Validation
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0040 GOVERNING BODY AND MANAGEMENT Condition
Q0240 INFECTION CONTROL Condition
Q0162 FORM AND CONTENT OF RECORD Standard
Q0241 SANITARY ENVIRONMENT Standard
Q0242 INFECTION CONTROL PROGRAM Standard
▼ 05C0001186 Gastroenterology Diagnostic Center Medical Group 880 South Atlantic Blvd, G10 Monterey Park CA 9 (San Francisco) 07/17/2018 S17221 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
E0024 Policies/Procedures-Volunteers and Staffing Standard
E0026 Roles Under a Waiver Declared by Secretary Standard
K0331 Interior Wall and Ceiling Finish Standard
K0346 Fire Alarm System - Out of Service Standard
▼ 05C0001186 Gastroenterology Diagnostic Center Medical Group 880 South Atlantic Blvd, G10 Monterey Park CA 9 (San Francisco) 07/12/2018 S17211 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0040 GOVERNING BODY AND MANAGEMENT Condition
Q0080 QUALITY ASSESSMENT AND PERFORMANCE Condition
Q0140 NURSING SERVICES Condition
Q0240 INFECTION CONTROL Condition
Q0081 PROGRAM SCOPE; PROGRAM ACTIVITIES Standard
Q0082 PROGRAM DATA; PROGRAM ACTIVITIES Standard
Q0083 PERFORMANCE IMPROVEMENT PROJECTS Standard
Q0105 EMERGENCY EQUIPMENT Standard
Q0141 ORGANIZATION AND STAFFING Standard
Q0162 FORM AND CONTENT OF RECORD Standard
Q0181 ADMINISTRATION OF DRUGS Standard
Q0241 SANITARY ENVIRONMENT Standard
Q0242 INFECTION CONTROL PROGRAM Standard
Q0243 INFECTION CONTROL PROGRAM - DIRECTION Standard
▼ 05C0001188 Starpoint Health 20360 Sw Birch St, Suite 110 Newport Beach CA 9 (San Francisco) 05/16/2019 CVXW21 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
E0006 Plan Based on All Hazards Risk Assessment Standard
E0020 Policies for Evac. and Primary/Alt. Comm. Standard
E0037 EP Training Program Standard
K0291 Emergency Lighting Standard
K0345 Fire Alarm System - Testing and Maintenance Standard
K0353 Sprinkler System - Maintenance and Testing Standard
K0355 Portable Fire Extinguishers Standard
K0521 HVAC Standard
K0712 Fire Drills Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
K0923 Electrical Equipment ? Ground-Fault Circuit-Interrupter Protection Standard
▼ 05C0001188 Starpoint Health 20360 Sw Birch St, Suite 110 Newport Beach CA 9 (San Francisco) 05/10/2019 CVXW11 Complaint, Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0040 GOVERNING BODY AND MANAGEMENT Condition
Q0060 SURGICAL SERVICES Condition
Q0080 QUALITY ASSESSMENT AND PERFORMANCE Condition
Q0002 DEFINITIONS Standard
Q0041 CONTRACT SERVICES Standard
Q0061 ANESTHETIC RISK AND EVALUATION Standard
Q0062 ANESTHETIC - DISCHARGE Standard
Q0063 ADMINISTRATION OF ANESTHESIA Standard
Q0064 STANDARD LEVEL TAG FOR SURGICAL SERVICES Standard
Q0081 PROGRAM SCOPE; PROGRAM ACTIVITIES Standard
Q0082 PROGRAM DATA; PROGRAM ACTIVITIES Standard
Q0084 GOVERNING BODY RESPONSIBILITIES Standard
Q0101 PHYSICAL ENVIRONMENT Standard
Q0121 MEMBERSHIP AND CLINICAL PRIVILEGES Standard
Q0141 ORGANIZATION AND STAFFING Standard
Q0162 FORM AND CONTENT OF RECORD Standard
Q0181 ADMINISTRATION OF DRUGS Standard
Q0241 SANITARY ENVIRONMENT Standard
Q0242 INFECTION CONTROL PROGRAM Standard
Q0244 INFECTION CONTROL PROGRAM - QAPI Standard
Q0261 PATIENT ASSESSMENT AND ADMISSION Standard
Q0262 ADMISSION AND PRE-SURGICAL ASSESSMENT Standard
▼ 05C0001193 Endoscopy Center Of Southern California 2336 Santa Monica Blvd # 204 Santa Monica CA 9 (San Francisco) 02/05/2018 QQLL21 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
K0331 Interior Wall and Ceiling Finish Standard
K0346 Fire Alarm System - Out of Service Standard
K0355 Portable Fire Extinguishers Standard
K0712 Fire Drills Standard
▼ 05C0001193 Endoscopy Center Of Southern California 2336 Santa Monica Blvd # 204 Santa Monica CA 9 (San Francisco) 02/01/2018 QQLL11 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0040 GOVERNING BODY AND MANAGEMENT Condition
Q0060 SURGICAL SERVICES Condition
Q0100 ENVIRONMENT Condition
Q0140 NURSING SERVICES Condition
Q0240 INFECTION CONTROL Condition
Q0061 ANESTHETIC RISK AND EVALUATION Standard
Q0101 PHYSICIAL ENVIRONMENT Standard
Q0141 ORGANIZATION AND STAFFING Standard
Q0181 ADMINISTRATION OF DRUGS Standard
Q0222 NOTICE OF RIGHTS - POSTING Standard
Q0232 SAFETY Standard
Q0241 SANITARY ENVIRONMENT Standard
Q0242 INFECTION CONTROL PROGRAM Standard
Q0264 POST-SURGICAL ASSESSMENT Standard
Q0266 DISCHARGE - ORDER Standard
▼ 05C0001194 De La Vina Surgicenter 2323 De La Vina St Ste 102 Santa Barbara CA 9 (San Francisco) 05/29/2019 VDMB21 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
E0020 Policies for Evac. and Primary/Alt. Comm. Standard
E0032 Primary/Alternate Means for Communication Standard
E0034 Information on Occupancy/Needs Standard
K0211 Means of Egress - General Standard
K0291 Emergency Lighting Standard
K0293 Exit Signage Standard
K0325 Alcohol Based Hand Rub Dispenser (ABHR) Standard
K0345 Fire Alarm System - Testing and Maintenance Standard
K0346 Fire Alarm System - Out of Service Standard
K0353 Sprinkler System - Maintenance and Testing Standard
K0354 Sprinkler System - Out of Service Standard
K0355 Portable Fire Extinguishers Standard
K0511 Utilities - Gas and Electric Standard
K0712 Fire Drills Standard
K0751 Draperies, Curtains, and Loosely Hanging Fabrics Standard
K0913 Electrical Systems - Wet Procedure Locations Standard
K0914 Electrical Systems - Maintenance and Testing Standard