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

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Provider Characteristics

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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
▼ 05C0001271 Madera Ambulatory Endoscopy Center 451 E Almond, #105 Madera CA 9 (San Francisco) 08/08/2018 4G8711 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0040 GOVERNING BODY AND MANAGEMENT Condition
Q0100 ENVIRONMENT Condition
Q0140 NURSING SERVICES Condition
Q0240 INFECTION CONTROL Condition
Q0002 DEFINITIONS Standard
Q0101 PHYSICIAL ENVIRONMENT Standard
Q0141 ORGANIZATION AND STAFFING Standard
Q0221 NOTICE OF RIGHTS Standard
Q0241 SANITARY ENVIRONMENT Standard
Q0242 INFECTION CONTROL PROGRAM Standard
Q0243 INFECTION CONTROL PROGRAM - DIRECTION Standard
Q0267 DISCHARGE WITH RESPONSIBLE ADULT Standard
▼ 05C0001272 United Surgery Center - Orange, Llc 1140 West La Veta Ave, Suite 550 Orange CA 9 (San Francisco) 03/04/2025 65711-L1 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
E0031 Emergency Officials Contact Information Standard
E0039 EP Testing Requirements Standard
K0161 Building Construction Type and Height 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
K0353 Sprinkler System - Maintenance and Testing Standard
K0511 Utilities - Gas and Electric Standard
K0761 Maintenance, Inspection & Testing - Doors Standard
K0911 Electrical Systems - Other Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
K0921 Electrical Equipment ? Testing and Maintenance Requirements Standard
▼ 05C0001272 United Surgery Center - Orange, Llc 1140 West La Veta Ave, Suite 550 Orange CA 9 (San Francisco) 02/26/2025 65711-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0041 CONTRACT SERVICES Standard
Q0061 ANESTHETIC RISK AND EVALUATION Standard
Q0123 OTHER PRACTITIONERS Standard
Q0141 ORGANIZATION AND STAFFING Standard
Q0162 FORM AND CONTENT OF RECORD Standard
Q0181 ADMINISTRATION OF DRUGS Standard
Q0242 INFECTION CONTROL PROGRAM Standard
Q0264 POST-SURGICAL ASSESSMENT Standard
▼ 05C0001272 United Surgery Center - Orange, Llc 1140 West La Veta Ave, Suite 550 Orange CA 9 (San Francisco) 09/11/2020 775E11 Complaint
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0225 SUBMISSION AND INVESTIGATION OF GRIEVANCES Standard
▼ 05C0001281 Palomar Surgical Center Escondido 2130 Citracado Parkway, Suite 100 Escondido CA 9 (San Francisco) 06/11/2025 66321-L1 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
E0031 Emergency Officials Contact Information Standard
K0291 Emergency Lighting Standard
K0293 Exit Signage 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
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
▼ 05C0001288 Southland Endoscopy Center 949 East Calhoun Place, Suite B Hemet CA 9 (San Francisco) 04/23/2025 65E74-L1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
E0018 Procedures for Tracking of Staff and Patients Standard
E0023 Policies/Procedures for Medical Documentation Standard
E0024 Policies/Procedures-Volunteers and Staffing Standard
E0026 Roles Under a Waiver Declared by Secretary Standard
E0032 Primary/Alternate Means for Communication Standard
E0034 Information on Occupancy/Needs Standard
E0039 EP Testing Requirements Standard
K0161 Building Construction Type and Height Standard
K0211 Means of Egress - General Standard
K0222 Egress Doors Standard
K0345 Fire Alarm System - Testing and Maintenance Standard
K0353 Sprinkler System - Maintenance and Testing Standard
K0355 Portable Fire Extinguishers Standard
K0912 Electrical Systems - Receptacles Standard
K0923 Electrical Equipment ? Ground-Fault Circuit-Interrupter Protection Standard
▼ 05C0001288 Southland Endoscopy Center 949 East Calhoun Place, Suite B Hemet CA 9 (San Francisco) 04/15/2025 65E74-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0064 STANDARD LEVEL TAG FOR SURGICAL SERVICES Standard
Q0102 SEPARATION Standard
Q0110 EMERGENCY PERSONNEL Standard
Q0181 ADMINISTRATION OF DRUGS Standard
Q0241 SANITARY ENVIRONMENT Standard
▼ 05C0001293 Merced Ambulatory Endoscopy Center 750 W Olive Ave, Suite 107a Merced CA 9 (San Francisco) 01/21/2020 CS7421 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
E0018 Procedures for Tracking of Staff and Patients Standard
E0020 Policies for Evac. and Primary/Alt. Comm. Standard
E0022 Policies/Procedures for Sheltering in Place Standard
E0023 Policies/Procedures for Medical Documentation Standard
E0024 Policies/Procedures-Volunteers and Staffing Standard
E0026 Roles Under a Waiver Declared by Secretary Standard
E0030 Names and Contact Information Standard
E0031 Emergency Officials Contact Information Standard
E0033 Methods for Sharing Information Standard
E0034 Information on Occupancy/Needs Standard
E0037 EP Training Program Standard
E0039 EP Testing Requirements Standard
K0211 Means of Egress - General Standard
K0291 Emergency Lighting Standard
K0293 Exit Signage Standard
K0300 Protection - Other Standard
K0341 Fire Alarm System - Installation Standard
K0345 Fire Alarm System - Testing and Maintenance Standard
K0355 Portable Fire Extinguishers Standard
K0521 HVAC Standard
K0712 Fire Drills Standard
K0914 Electrical Systems - Maintenance and Testing Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
K0919 Electrical Equipment - Other Standard
▼ 05C0001293 Merced Ambulatory Endoscopy Center 750 W Olive Ave, Suite 107a Merced CA 9 (San Francisco) 01/08/2020 CS7411 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
Q0240 INFECTION CONTROL Condition
Q0084 GOVERNING BODY RESPONSIBILITIES Standard
Q0242 INFECTION CONTROL PROGRAM Standard
Q0243 INFECTION CONTROL PROGRAM - DIRECTION Standard
Q0244 INFECTION CONTROL PROGRAM - QAPI Standard
▼ 05C0001296 Valley Endoscopy Center 397 North San Jacinto Street Hemet CA 9 (San Francisco) 08/19/2025 1D3435-L1 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
E0039 EP Testing Requirements 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
K0354 Sprinkler System - Out of Service Standard
K0355 Portable Fire Extinguishers Standard
K0374 Subdivision of Building Spaces ? Smoke Barrier Doors Standard
K0923 Electrical Equipment ? Ground-Fault Circuit-Interrupter Protection Standard