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
▼ 05C0001630 Med-Laser Surgical Center 2445 West Whittier Blvd Montebello CA 9 (San Francisco) 11/26/2018 I5Y911 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0240 INFECTION CONTROL Condition
Q0141 ORGANIZATION AND STAFFING Standard
Q0162 FORM AND CONTENT OF RECORD Standard
Q0181 ADMINISTRATION OF DRUGS Standard
Q0224 ADVANCED DIRECTIVES Standard
Q0229 EXERCISE OF RIGHTS - INFORMED CONSENT Standard
Q0241 SANITARY ENVIRONMENT Standard
Q0267 DISCHARGE WITH RESPONSIBLE ADULT Standard
▼ 05C0001631 Newport Multi Specialty Surgery Center, Llc 400 Newport Center Drive, #102 Newport Beach CA 9 (San Francisco) 07/06/2018 2TWD21 Recertification, Sample Validation
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
E0036 EP Training and Testing Standard
K0211 Means of Egress - General Standard
K0291 Emergency Lighting Standard
K0345 Fire Alarm System - Testing and Maintenance Standard
K0346 Fire Alarm System - Out of Service Standard
K0353 Sprinkler System - Maintenance and Testing Standard
K0712 Fire Drills Standard
K0907 Gas and Vacuum Piped Systems ? Central Supply System Location Standard
K0914 Electrical Systems - Maintenance and Testing Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
K0933 Features of Fire Protection ? Fire Loss Prevention Standard
▼ 05C0001631 Newport Multi Specialty Surgery Center, Llc 400 Newport Center Drive, #102 Newport Beach CA 9 (San Francisco) 06/29/2018 2TWD11 Recertification, Sample Validation
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
Q0120 MEDICAL STAFF Condition
Q0240 INFECTION CONTROL Condition
Q0002 DEFINITIONS Standard
Q0041 CONTRACT SERVICES Standard
Q0061 ANESTHETIC RISK AND EVALUATION Standard
Q0064 STANDARD LEVEL TAG FOR SURGICAL SERVICES Standard
Q0081 PROGRAM SCOPE; PROGRAM ACTIVITIES Standard
Q0082 PROGRAM DATA; PROGRAM ACTIVITIES Standard
Q0083 PERFORMANCE IMPROVEMENT PROJECTS Standard
Q0084 GOVERNING BODY RESPONSIBILITIES Standard
Q0101 PHYSICIAL ENVIRONMENT Standard
Q0104 SAFETY FROM FIRE Standard
Q0105 EMERGENCY EQUIPMENT Standard
Q0121 MEMBERSHIP AND CLINICAL PRIVILEGES Standard
Q0122 REAPPRAISALS Standard
Q0123 OTHER PRACTITIONERS Standard
Q0141 ORGANIZATION AND STAFFING Standard
Q0162 FORM AND CONTENT OF RECORD Standard
Q0181 ADMINISTRATION OF DRUGS Standard
Q0201 LABORATORY SERVICES Standard
Q0241 SANITARY ENVIRONMENT Standard
Q0242 INFECTION CONTROL PROGRAM Standard
Q0243 INFECTION CONTROL PROGRAM - DIRECTION Standard
Q0244 INFECTION CONTROL PROGRAM - QAPI Standard
Q0261 ADMISSION ASSESSMENT Standard
Q0265 DISCHARGE - SUPPLIES AND INFORMATION Standard
Q0267 DISCHARGE WITH RESPONSIBLE ADULT Standard
▼ 05C0001632 Pacific Endoscopy Llc 3351 El Camino Real, Suite 220 Atherton CA 9 (San Francisco) 05/19/2025 65E54-L1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
K0291 Emergency Lighting Standard
K0293 Exit Signage Standard
K0913 Electrical Systems - Wet Procedure Locations Standard
K0919 Electrical Equipment - Other Standard
▼ 05C0001632 Pacific Endoscopy Llc 3351 El Camino Real, Suite 220 Atherton CA 9 (San Francisco) 04/17/2025 65E54-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0007 ADMINISTRATION OF ANESTHESIA Standard
▼ 05C0001633 Posada Ambulatory Surgery Center 322 Posada Lane, Suite B Templeton CA 9 (San Francisco) 09/05/2019 WTJR21 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
E0006 Plan Based on All Hazards Risk Assessment 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
E0026 Roles Under a Waiver Declared by Secretary Standard
E0033 Methods for Sharing Information Standard
E0039 EP Testing Requirements Standard
K0161 Building Construction Type and Height Standard
K0291 Emergency Lighting Standard
K0293 Exit Signage Standard
K0300 Protection - Other Standard
K0321 Hazardous Areas - Enclosure Standard
K0323 Anesthetizing Locations 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
K0712 Fire Drills Standard
K0913 Electrical Systems - Wet Procedure Locations Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
K0919 Electrical Equipment - Other Standard
K0920 Electrical Equipment ? Power Cords and Extension Cords Standard
▼ 05C0001633 Posada Ambulatory Surgery Center 322 Posada Lane, Suite B Templeton CA 9 (San Francisco) 08/20/2019 WTJR11 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0240 INFECTION CONTROL Condition
Q0002 DEFINITIONS Standard
Q0101 PHYSICAL ENVIRONMENT Standard
Q0110 EMERGENCY PERSONNEL Standard
Q0162 FORM AND CONTENT OF RECORD Standard
Q0181 ADMINISTRATION OF DRUGS Standard
Q0224 ADVANCED DIRECTIVES Standard
Q0241 SANITARY ENVIRONMENT Standard
Q0261 PATIENT ASSESSMENT AND ADMISSION Standard
▼ 05C0001635 Sacramento Surgery Center Associates, L.P. 1800 Tribute Road, Suite #100 Sacramento CA 9 (San Francisco) 03/23/2026 1F2C7E-L1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
E0037 EP Training Program Standard
K0345 Fire Alarm System - Testing and Maintenance Standard
K0712 Fire Drills Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
K0920 Electrical Equipment ? Power Cords and Extension Cords Standard
▼ 05C0001635 Sacramento Surgery Center Associates, L.P. 1800 Tribute Road, Suite #100 Sacramento CA 9 (San Francisco) 08/10/2018 BV3U21 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
K0346 Fire Alarm System - Out of Service Standard
K0354 Sprinkler System - Out of Service Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
▼ 05C0001635 Sacramento Surgery Center Associates, L.P. 1800 Tribute Road, Suite #100 Sacramento CA 9 (San Francisco) 05/10/2018 BV3U11 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0080 QUALITY ASSESSMENT AND PERFORMANCE Condition
Q0082 PROGRAM DATA; PROGRAM ACTIVITIES Standard
Q0181 ADMINISTRATION OF DRUGS Standard
Q0220 NOTICE - POSTING Standard
Q0242 INFECTION CONTROL PROGRAM Standard
Q0261 ADMISSION ASSESSMENT Standard
Q0262 PRE-SURGICAL ASSESSMENT Standard
Q0264 POST-SURGICAL ASSESSMENT Standard