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
▼ 50C0001228 Peninsula Endoscopy Center 2727 Hollycroft St, Suite 480 Gig Harbor WA 10 (Seattle) 01/21/2026 1E0384-L1 Recertification
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0291 Emergency Lighting Standard
▼ 50C0001228 Peninsula Endoscopy Center 2727 Hollycroft St, Suite 480 Gig Harbor WA 10 (Seattle) 03/20/2023 5F451-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
Q0181 ADMINISTRATION OF DRUGS Standard
Q0242 INFECTION CONTROL PROGRAM Standard
▼ 50C0001228 Peninsula Endoscopy Center 2727 Hollycroft St, Suite 480 Gig Harbor WA 10 (Seattle) 03/20/2023 5F451-L1 Recertification
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0353 Sprinkler System - Maintenance and Testing Standard
▼ 50C0001228 Peninsula Endoscopy Center 2727 Hollycroft St, Suite 480 Gig Harbor WA 10 (Seattle) 03/06/2018 1DLK21 Recertification
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0293 Exit Signage Standard
K0353 Sprinkler System - Maintenance and Testing Standard
K0355 Portable Fire Extinguishers Standard
K0902 Gas and Vacuum Piped Systems - Other Standard
▼ 50C0001228 Peninsula Endoscopy Center 2727 Hollycroft St, Suite 480 Gig Harbor WA 10 (Seattle) 02/27/2018 1DLK11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
E0029 Development of Communication Plan Standard
E0033 Methods for Sharing Information Standard
E0034 Information on Occupancy/Needs Standard
Q0101 PHYSICIAL ENVIRONMENT Standard
Q0104 SAFETY FROM FIRE Standard
Q0181 ADMINISTRATION OF DRUGS Standard
Q0184 VERBAL ORDERS Standard
Q0201 LABORATORY SERVICES Standard
Q0224 ADVANCED DIRECTIVES Standard
Q0241 SANITARY ENVIRONMENT Standard
▼ 50C0001229 Proliance Surgeons Inc P.S. 3801 5th Street Se Puyallup WA 10 (Seattle) 05/01/2025 658C1-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0104 SAFETY FROM FIRE Standard
Q0242 INFECTION CONTROL PROGRAM Standard
▼ 50C0001229 Proliance Surgeons Inc P.S. 3801 5th Street Se Puyallup WA 10 (Seattle) 05/01/2025 658C1-L1 Recertification
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0131 Multiple Occupancies Standard
K0345 Fire Alarm System - Testing and Maintenance Standard
K0353 Sprinkler System - Maintenance and Testing Standard
K0511 Utilities - Gas and Electric Standard
K0521 HVAC Standard
K0531 Elevators Standard
K0711 Evacuation and Relocation Plan Standard
K0712 Fire Drills Standard
K0761 Maintenance, Inspection & Testing - Doors Standard
K0914 Electrical Systems - Maintenance and Testing Standard
K0915 Essential Electrical Systems ? Type 1 and Type 2 Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
K0920 Electrical Equipment ? Power Cords and Extension Cords Standard
K0933 Features of Fire Protection ? Fire Loss Prevention Standard
▼ 50C0001229 Proliance Surgeons Inc P.S. 3801 5th Street Se Puyallup WA 10 (Seattle) 09/08/2022 4F192-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
E0023 Policies/Procedures for Medical Documentation Standard
E0024 Policies/Procedures-Volunteers and Staffing Standard
Q0101 PHYSICAL ENVIRONMENT Standard
Q0104 SAFETY FROM FIRE Standard
Q0121 MEMBERSHIP AND CLINICAL PRIVILEGES Standard
Q0122 REAPPRAISALS Standard
Q0141 ORGANIZATION AND STAFFING Standard
Q0181 ADMINISTRATION OF DRUGS Standard
Q0204 RADIOLOGIC SERVICES Standard
Q0242 INFECTION CONTROL PROGRAM Standard
Q0246 COVID-19 Vaccination of Facility Staff Standard
Q0262 ADMISSION AND PRE-SURGICAL ASSESSMENT Standard
▼ 50C0001229 Proliance Surgeons Inc P.S. 3801 5th Street Se Puyallup WA 10 (Seattle) 09/08/2022 4F192-L1 Recertification
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0131 Multiple Occupancies 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
K0761 Maintenance, Inspection & Testing - Doors Standard
K0914 Electrical Systems - Maintenance and Testing Standard
K0915 Essential Electrical Systems ? Type 1 and Type 2 Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
K0926 Gas Equipment - Qualifications and Training Standard
▼ 50C0001229 Proliance Surgeons Inc P.S. 3801 5th Street Se Puyallup WA 10 (Seattle) 11/10/2020 1LE711 Focused Infection Control, Other-Fed
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0242 INFECTION CONTROL PROGRAM Standard
Q0245 INFECTION CONTROL PROGRAM Standard