S&C QCOR ASC 2567s
d QCOR: Quality, Certification and Oversight Reports. S&C QCOR  
Home  |  Help  |  Resources  |  FAQs  |  Site Map  
   
ASCs 2567s
Selection Criteria ▸

Time Interval

Please select the calendar year or years for which you would like data.

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
▼ 50C0001095 Gh Evergreen Endoscopy Center Sub Llc 11800 128th St, Ste 100 Kirkland WA 10 (Seattle) 04/27/2021 0WPB21 Recertification
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0345 Fire Alarm System - Testing and Maintenance Standard
K0353 Sprinkler System - Maintenance and Testing Standard
K0712 Fire Drills Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
K0920 Electrical Equipment ? Power Cords and Extension Cords Standard
▼ 50C0001126 Waldron Endoscopy Ctr Llc 3209 S 23rd Street Second Floor Tacoma WA 10 (Seattle) 03/11/2026 1E3D92-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0104 SAFETY FROM FIRE Standard
Q0229 EXERCISE OF RIGHTS - INFORMED CONSENT Standard
▼ 50C0001126 Waldron Endoscopy Ctr Llc 3209 S 23rd Street Second Floor Tacoma WA 10 (Seattle) 03/11/2026 1E3D92-L1 Recertification
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0353 Sprinkler System - Maintenance and Testing Standard
K0781 Portable Space Heaters Standard
▼ 50C0001126 Waldron Endoscopy Ctr Llc 3209 S 23rd Street Second Floor Tacoma WA 10 (Seattle) 01/09/2023 5E915-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0042 HOSPITALIZATION Standard
Q0246 COVID-19 Vaccination of Facility Staff Standard
▼ 50C0001126 Waldron Endoscopy Ctr Llc 3209 S 23rd Street Second Floor Tacoma WA 10 (Seattle) 01/09/2023 5E915-L1 Recertification
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0353 Sprinkler System - Maintenance and Testing Standard
▼ 50C0001128 Olympia Multi-Speciality Clinic Ambulatory Procedure Center 3920 Capital Mall Drive Sw Olympia WA 10 (Seattle) 12/28/2023 BBWN-L1 Recertification
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0131 Multiple Occupancies Standard
K0345 Fire Alarm System - Testing and Maintenance Standard
K0346 Fire Alarm System - Out of Service Standard
K0353 Sprinkler System - Maintenance and Testing Standard
K0355 Portable Fire Extinguishers Standard
K0521 HVAC Standard
K0712 Fire Drills Standard
K0751 Draperies, Curtains, and Loosely Hanging Fabrics Standard
K0761 Maintenance, Inspection & Testing - Doors Standard
K0907 Gas and Vacuum Piped Systems ? Central Supply System Location Standard
K0913 Electrical Systems - Wet Procedure Locations Standard
K0914 Electrical Systems - Maintenance and Testing Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
K0920 Electrical Equipment ? Power Cords and Extension Cords Standard
▼ 50C0001128 Olympia Multi-Speciality Clinic Ambulatory Procedure Center 3920 Capital Mall Drive Sw Olympia WA 10 (Seattle) 12/28/2023 C3Y2-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
E0007 EP Program Patient Population Standard
E0009 Local, State, Tribal Collaboration Process 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
E0024 Policies/Procedures-Volunteers and Staffing Standard
E0029 Development of Communication Plan Standard
E0030 Names and Contact Information Standard
E0032 Primary/Alternate Means for Communication Standard
E0034 Information on Occupancy/Needs Standard
E0036 EP Training and Testing Standard
E0037 EP Training Program Standard
E0039 EP Testing Requirements Standard
Q0162 FORM AND CONTENT OF RECORD Standard
Q0223 NOTICE - PHYSICIAN OWNERSHIP Standard
Q0241 SANITARY ENVIRONMENT Standard
▼ 50C0001128 Olympia Multi-Speciality Clinic Ambulatory Procedure Center 3920 Capital Mall Drive Sw Olympia WA 10 (Seattle) 03/16/2020 5N5E11 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
E0004 Develop EP Plan, Review and Update Annually Standard
E0007 EP Program Patient Population Standard
E0022 Policies/Procedures for Sheltering in Place Standard
E0024 Policies/Procedures-Volunteers and Staffing Standard
E0026 Roles Under a Waiver Declared by Secretary Standard
E0039 EP Testing Requirements Standard
Q0101 PHYSICAL ENVIRONMENT Standard
Q0104 SAFETY FROM FIRE Standard
Q0121 MEMBERSHIP AND CLINICAL PRIVILEGES Standard
Q0122 REAPPRAISALS Standard
Q0141 ORGANIZATION AND STAFFING Standard
Q0162 FORM AND CONTENT OF RECORD Standard
Q0181 ADMINISTRATION OF DRUGS Standard
Q0223 NOTICE - PHYSICIAN OWNERSHIP Standard
Q0229 EXERCISE OF RIGHTS - INFORMED CONSENT Standard
Q0233 SAFETY - ABUSE/HARASSMENT Standard
Q0241 SANITARY ENVIRONMENT Standard
Q0242 INFECTION CONTROL PROGRAM Standard
Q0245 INFECTION CONTROL PROGRAM Standard
▼ 50C0001128 Olympia Multi-Speciality Clinic Ambulatory Procedure Center 3920 Capital Mall Drive Sw Olympia WA 10 (Seattle) 03/16/2020 5N5E21 Recertification
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0353 Sprinkler System - Maintenance and Testing Standard
K0712 Fire Drills Standard
K0761 Maintenance, Inspection & Testing - Doors Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
▼ 50C0001131 Evergreen Eye Surgery Center 34719 6th Avenue South Federal Way WA 10 (Seattle) 12/18/2025 1DDB7A-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
Q0100 ENVIRONMENT Condition
E0004 Develop EP Plan, Review and Update Annually Standard
E0030 Names and Contact Information Standard
E0037 EP Training Program Standard
Q0064 STANDARD LEVEL TAG FOR SURGICAL SERVICES Standard
Q0104 SAFETY FROM FIRE Standard
Q0109 EMERGENCY EQUIPMENT Standard
Q0121 MEMBERSHIP AND CLINICAL PRIVILEGES Standard
Q0122 REAPPRAISALS Standard
Q0181 ADMINISTRATION OF DRUGS Standard
Q0241 SANITARY ENVIRONMENT Standard
Q0242 INFECTION CONTROL PROGRAM Standard