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
▼ 55C0001002 Spencer Eye Surgery And Laser Center 2486 Ponderosa Dr N Ste D-110 Camarillo CA 9 (San Francisco) 09/18/2018 IO3D21 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
E0013 Development of EP Policies and Procedures Standard
E0029 Development of Communication Plan Standard
E0036 EP Training and Testing Standard
K0223 Doors with Self-Closing Devices Standard
K0321 Hazardous Areas - Enclosure Standard
K0345 Fire Alarm System - Testing and Maintenance Standard
K0712 Fire Drills Standard
K0912 Electrical Systems - Receptacles Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
▼ 55C0001002 Spencer Eye Surgery And Laser Center 2486 Ponderosa Dr N Ste D-110 Camarillo CA 9 (San Francisco) 07/24/2018 IO3D11 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0041 CONTRACT SERVICES Standard
Q0101 PHYSICIAL ENVIRONMENT Standard
Q0105 EMERGENCY EQUIPMENT Standard
Q0141 ORGANIZATION AND STAFFING Standard
Q0181 ADMINISTRATION OF DRUGS Standard
Q0221 NOTICE OF RIGHTS Standard
Q0224 ADVANCED DIRECTIVES Standard
Q0225 SUBMISSION AND INVESTIGATION OF GRIEVANCES Standard
Q0242 INFECTION CONTROL PROGRAM Standard
▼ 55C0001003 Lynn Eye Surgery Center 2230 Lynn Road Thousand Oaks CA 9 (San Francisco) 05/06/2025 65C16-H1 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
Q0160 MEDICAL RECORDS Condition
Q0240 INFECTION CONTROL Condition
Q0081 PROGRAM SCOPE; PROGRAM ACTIVITIES Standard
Q0101 PHYSICAL ENVIRONMENT Standard
Q0141 ORGANIZATION AND STAFFING Standard
Q0162 FORM AND CONTENT OF RECORD Standard
Q0181 ADMINISTRATION OF DRUGS Standard
Q0220 NOTICE - POSTING Standard
Q0221 NOTICE OF RIGHTS Standard
Q0241 SANITARY ENVIRONMENT Standard
Q0242 INFECTION CONTROL PROGRAM Standard
▼ 55C0001003 Lynn Eye Surgery Center 2230 Lynn Road Thousand Oaks CA 9 (San Francisco) 04/30/2025 65C16-L1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
K0323 Anesthetizing Locations Standard
K0345 Fire Alarm System - Testing and Maintenance Standard
K0353 Sprinkler System - Maintenance and Testing Standard
▼ 55C0001003 Lynn Eye Surgery Center 2230 Lynn Road Thousand Oaks CA 9 (San Francisco) 10/08/2020 8EQY11 Complaint
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0060 SURGICAL SERVICES Condition
Q0041 CONTRACT SERVICES Standard
Q0064 STANDARD LEVEL TAG FOR SURGICAL SERVICES Standard
▼ 55C0001006 Westlake Eye Surgery Center 2900 Townsgate Rd Ste 201 Westlake Village CA 9 (San Francisco) 12/06/2022 4F4A9-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0060 SURGICAL SERVICES Condition
Q0064 STANDARD LEVEL TAG FOR SURGICAL SERVICES Standard
Q0229 EXERCISE OF RIGHTS - INFORMED CONSENT Standard
▼ 55C0001006 Westlake Eye Surgery Center 2900 Townsgate Rd Ste 201 Westlake Village CA 9 (San Francisco) 06/13/2019 XCK921 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
E0031 Emergency Officials Contact Information Standard
E0039 EP Testing Requirements Standard
K0211 Means of Egress - General Standard
K0300 Protection - Other Standard
K0372 Subdivision of Building Spaces ? Smoke Barrier Construction Standard
K0531 Elevators Standard
K0761 Maintenance, Inspection & Testing - Doors Standard
K0914 Electrical Systems - Maintenance and Testing Standard
K0923 Electrical Equipment ? Ground-Fault Circuit-Interrupter Protection Standard
▼ 55C0001006 Westlake Eye Surgery Center 2900 Townsgate Rd Ste 201 Westlake Village CA 9 (San Francisco) 03/29/2019 XCK911 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
Q0000 Initial Comments - Not a Deficiency Citation Memo
E0020 Policies for Evac. and Primary/Alt. Comm. Standard
E0023 Policies/Procedures for Medical Documentation Standard
E0030 Names and Contact Information Standard
Q0162 FORM AND CONTENT OF RECORD Standard
Q0181 ADMINISTRATION OF DRUGS Standard
Q0232 SAFETY Standard
Q0241 SANITARY ENVIRONMENT Standard
▼ 55C0001020 Ophthalmology Medical Center 26701 Crown Valley Parkway Mission Viejo CA 9 (San Francisco) 03/05/2020 LX1B21 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
E0007 EP Program Patient Population Standard
E0009 Local, State, Tribal Collaboration Process Standard
E0024 Policies/Procedures-Volunteers and Staffing Standard
E0026 Roles Under a Waiver Declared by Secretary Standard
K0345 Fire Alarm System - Testing and Maintenance Standard
K0354 Sprinkler System - Out of Service Standard
K0511 Utilities - Gas and Electric Standard
K0521 HVAC Standard
K0907 Gas and Vacuum Piped Systems ? Central Supply System Location Standard
K0909 Gas and Vacuum Piped Systems ? Central Supply System Valves Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
K0920 Electrical Equipment ? Power Cords and Extension Cords Standard
▼ 55C0001020 Ophthalmology Medical Center 26701 Crown Valley Parkway Mission Viejo CA 9 (San Francisco) 02/26/2020 LX1B11 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0041 CONTRACT SERVICES Standard
Q0042 HOSPITALIZATION Standard
Q0064 STANDARD LEVEL TAG FOR SURGICAL SERVICES Standard
Q0082 PROGRAM DATA; PROGRAM ACTIVITIES Standard
Q0083 PERFORMANCE IMPROVEMENT PROJECTS Standard
Q0109 EMERGENCY EQUIPMENT 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
Q0203 RADIOLOGIC SERVICES Standard
Q0222 NOTICE OF RIGHTS - POSTING Standard
Q0224 ADVANCED DIRECTIVES Standard
Q0241 SANITARY ENVIRONMENT Standard
Q0242 INFECTION CONTROL PROGRAM Standard
Q0244 INFECTION CONTROL PROGRAM - QAPI Standard
Q0265 DISCHARGE - SUPPLIES AND INFORMATION Standard