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
▼ 05C0001211 Endoscopy Center Of The S Bay,The 23560 Madison St, Suite 109 Torrance CA 9 (San Francisco) 02/28/2018 RCBV21 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
K0321 Hazardous Areas - Enclosure Standard
K0331 Interior Wall and Ceiling Finish Standard
K0355 Portable Fire Extinguishers Standard
K0712 Fire Drills Standard
K0929 Gas Equipment ? Precautions for Handling Oxygen Standard
▼ 05C0001211 Endoscopy Center Of The S Bay,The 23560 Madison St, Suite 109 Torrance CA 9 (San Francisco) 02/16/2018 RCBV11 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
Q0120 MEDICAL STAFF Condition
Q0240 INFECTION CONTROL Condition
Q0081 PROGRAM SCOPE; PROGRAM ACTIVITIES Standard
Q0082 PROGRAM DATA; PROGRAM ACTIVITIES Standard
Q0083 PERFORMANCE IMPROVEMENT PROJECTS Standard
Q0084 GOVERNING BODY RESPONSIBILITIES Standard
Q0121 MEMBERSHIP AND CLINICAL PRIVILEGES Standard
Q0123 OTHER PRACTITIONERS Standard
Q0141 ORGANIZATION AND STAFFING Standard
Q0233 SAFETY - ABUSE/HARASSMENT Standard
Q0241 SANITARY ENVIRONMENT Standard
Q0242 INFECTION CONTROL PROGRAM Standard
Q0244 INFECTION CONTROL PROGRAM - QAPI Standard
Q0245 INFECTION CONTROL PROGRAM Standard
▼ 05C0001215 Los Robles Surgicenter 2190 Lynn Rd Ste 100 Thousand Oaks CA 9 (San Francisco) 07/10/2024 6369F-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0221 NOTICE OF RIGHTS Standard
▼ 05C0001215 Los Robles Surgicenter 2190 Lynn Rd Ste 100 Thousand Oaks CA 9 (San Francisco) 05/17/2019 IW5V21 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
E0026 Roles Under a Waiver Declared by Secretary Standard
E0033 Methods for Sharing Information Standard
E0037 EP Training Program Standard
K0211 Means of Egress - General Standard
K0345 Fire Alarm System - Testing and Maintenance Standard
K0353 Sprinkler System - Maintenance and Testing Standard
K0521 HVAC Standard
K0712 Fire Drills Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
▼ 05C0001215 Los Robles Surgicenter 2190 Lynn Rd Ste 100 Thousand Oaks CA 9 (San Francisco) 04/10/2019 IW5V11 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0162 FORM AND CONTENT OF RECORD Standard
Q0181 ADMINISTRATION OF DRUGS Standard
Q0184 VERBAL ORDERS Standard
Q0222 NOTICE OF RIGHTS - POSTING Standard
Q0224 ADVANCED DIRECTIVES Standard
Q0241 SANITARY ENVIRONMENT Standard
▼ 05C0001215 Los Robles Surgicenter 2190 Lynn Rd Ste 100 Thousand Oaks CA 9 (San Francisco) 07/13/2018 7P9N11 Complaint
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0225 SUBMISSION AND INVESTIGATION OF GRIEVANCES Standard
▼ 05C0001220 The Montebello Surgery Center 229 E Beverly Blvd Montebello CA 9 (San Francisco) 09/17/2018 0M0X21 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
E0009 Local, State, Tribal Collaboration Process Standard
E0024 Policies/Procedures-Volunteers and Staffing Standard
E0026 Roles Under a Waiver Declared by Secretary Standard
K0331 Interior Wall and Ceiling Finish Standard
K0712 Fire Drills Standard
K0751 Draperies, Curtains, and Loosely Hanging Fabrics Standard
K0929 Gas Equipment ? Precautions for Handling Oxygen Standard
▼ 05C0001220 The Montebello Surgery Center 229 E Beverly Blvd Montebello CA 9 (San Francisco) 08/16/2018 0M0X11 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
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
Q0084 GOVERNING BODY RESPONSIBILITIES Standard
Q0122 REAPPRAISALS Standard
Q0141 ORGANIZATION AND STAFFING Standard
Q0162 FORM AND CONTENT OF RECORD Standard
Q0224 ADVANCED DIRECTIVES Standard
Q0231 PRIVACY Standard
Q0241 SANITARY ENVIRONMENT Standard
Q0242 INFECTION CONTROL PROGRAM Standard
Q0243 INFECTION CONTROL PROGRAM - DIRECTION Standard
Q0261 PATIENT ASSESSMENT AND ADMISSION Standard
▼ 05C0001223 Bedford Plastic Surgery Center 436 N Bedford, Suite 103 Beverly Hills CA 9 (San Francisco) 03/24/2026 22BDF1-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0162 FORM AND CONTENT OF RECORD Standard
Q0261 PATIENT ASSESSMENT AND ADMISSION Standard
▼ 05C0001228 Aestheticare Outpatient Surgery Center 30260 Rancho Viejo Road San Juan Capistrano CA 9 (San Francisco) 06/20/2019 JO4D21 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
E0009 Local, State, Tribal Collaboration Process Standard
E0022 Policies/Procedures for Sheltering in Place Standard
E0031 Emergency Officials Contact Information Standard
E0033 Methods for Sharing Information Standard
E0039 EP Testing Requirements Standard
K0345 Fire Alarm System - Testing and Maintenance Standard
K0353 Sprinkler System - Maintenance and Testing Standard
K0521 HVAC Standard
K0712 Fire Drills Standard
K0908 Gas and Vacuum Piped Systems ? Central Supply System Alarms Standard
K0914 Electrical Systems - Maintenance and Testing Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard