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
▼ 55C0001061 Pacific Eye Institute 555 N 13th Avenue Upland CA 9 (San Francisco) 07/17/2025 669F3-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
Q0200 LABORATORY AND RADIOLOGIC SERVICES Condition
Q0219 PATIENT RIGHTS Condition
Q0240 INFECTION CONTROL Condition
Q0041 CONTRACT SERVICES Standard
Q0081 PROGRAM SCOPE; PROGRAM ACTIVITIES Standard
Q0082 PROGRAM DATA; PROGRAM ACTIVITIES Standard
Q0084 GOVERNING BODY RESPONSIBILITIES Standard
Q0109 EMERGENCY EQUIPMENT Standard
Q0201 LABORATORY SERVICES Standard
Q0220 NOTICE - POSTING Standard
Q0232 SAFETY Standard
Q0242 INFECTION CONTROL PROGRAM Standard
Q0245 INFECTION CONTROL PROGRAM Standard
▼ 55C0001062 Sacramento Eye Surgicenter 3150 J Street Sacramento CA 9 (San Francisco) 04/30/2018 L9CZ21 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
E0006 Plan Based on All Hazards Risk Assessment Standard
E0013 Development of EP Policies and Procedures Standard
K0161 Building Construction Type and Height Standard
K0211 Means of Egress - General Standard
K0223 Doors with Self-Closing Devices Standard
K0232 Aisle, Corridor, or Ramp Width Standard
K0293 Exit Signage 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
K0372 Subdivision of Building Spaces ? Smoke Barrier Construction Standard
K0500 Building Services - Other Standard
K0908 Gas and Vacuum Piped Systems ? Central Supply System Alarms Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
K0920 Electrical Equipment ? Power Cords and Extension Cords Standard
▼ 55C0001062 Sacramento Eye Surgicenter 3150 J Street Sacramento CA 9 (San Francisco) 04/19/2018 L9CZ11 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0140 NURSING SERVICES Condition
Q0101 PHYSICIAL ENVIRONMENT Standard
Q0141 ORGANIZATION AND STAFFING Standard
Q0241 SANITARY ENVIRONMENT Standard
▼ 55C0001076 Plastic Surg Assoc Of Orange County 1310 Stewart Drive, Suite 610 Orange CA 9 (San Francisco) 07/10/2019 31OU21 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
E0022 Policies/Procedures for Sheltering in Place Standard
E0026 Roles Under a Waiver Declared by Secretary Standard
E0032 Primary/Alternate Means for Communication Standard
E0033 Methods for Sharing Information Standard
E0036 EP Training and Testing Standard
E0039 EP Testing Requirements Standard
K0345 Fire Alarm System - Testing and Maintenance Standard
K0353 Sprinkler System - Maintenance and Testing Standard
K0521 HVAC Standard
K0712 Fire Drills 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
▼ 55C0001076 Plastic Surg Assoc Of Orange County 1310 Stewart Drive, Suite 610 Orange CA 9 (San Francisco) 06/19/2019 31OU11 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0041 CONTRACT SERVICES Standard
Q0081 PROGRAM SCOPE; PROGRAM ACTIVITIES Standard
Q0084 GOVERNING BODY RESPONSIBILITIES Standard
Q0101 PHYSICAL ENVIRONMENT Standard
Q0109 EMERGENCY EQUIPMENT Standard
Q0121 MEMBERSHIP AND CLINICAL PRIVILEGES Standard
Q0141 ORGANIZATION AND STAFFING Standard
Q0162 FORM AND CONTENT OF RECORD Standard
Q0181 ADMINISTRATION OF DRUGS Standard
Q0229 EXERCISE OF RIGHTS - INFORMED CONSENT Standard
Q0241 SANITARY ENVIRONMENT Standard
Q0242 INFECTION CONTROL PROGRAM Standard
Q0243 INFECTION CONTROL PROGRAM - DIRECTION Standard
Q0244 INFECTION CONTROL PROGRAM - QAPI Standard
Q0264 POST-SURGICAL ASSESSMENT Standard
Q0265 DISCHARGE - SUPPLIES AND INFORMATION Standard
Q0267 DISCHARGE WITH RESPONSIBLE ADULT Standard
▼ 55C0001083 Sacramento Midtown Endoscopy Center, Llc 3941 J Street, Suite 460 Sacramento CA 9 (San Francisco) 05/19/2025 66011-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
E0013 Development of EP Policies and Procedures Standard
E0029 Development of Communication Plan Standard
E0036 EP Training and Testing Standard
K0222 Egress Doors Standard
K0323 Anesthetizing Locations Standard
K0345 Fire Alarm System - Testing and Maintenance Standard
K0355 Portable Fire Extinguishers Standard
K0712 Fire Drills Standard
K0913 Electrical Systems - Wet Procedure Locations Standard
▼ 55C0001083 Sacramento Midtown Endoscopy Center, Llc 3941 J Street, Suite 460 Sacramento CA 9 (San Francisco) 05/15/2025 66011-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
Q0120 MEDICAL STAFF Condition
Q0240 INFECTION CONTROL Condition
Q0041 CONTRACT SERVICES Standard
Q0081 PROGRAM SCOPE; PROGRAM ACTIVITIES Standard
Q0082 PROGRAM DATA; PROGRAM ACTIVITIES Standard
Q0083 PERFORMANCE IMPROVEMENT PROJECTS Standard
Q0084 GOVERNING BODY RESPONSIBILITIES Standard
Q0121 MEMBERSHIP AND CLINICAL PRIVILEGES Standard
Q0122 REAPPRAISALS Standard
Q0162 FORM AND CONTENT OF RECORD Standard
Q0223 NOTICE - PHYSICIAN OWNERSHIP Standard
Q0243 INFECTION CONTROL PROGRAM - DIRECTION Standard
Q0245 INFECTION CONTROL PROGRAM Standard
▼ 55C0001098 Sebastopol Asc Lp 6880 Palm Avenue Sebastopol CA 9 (San Francisco) 09/11/2018 ZJ6Q21 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
K0291 Emergency Lighting Standard
K0323 Anesthetizing Locations Standard
K0341 Fire Alarm System - Installation Standard
K0346 Fire Alarm System - Out of Service Standard
K0353 Sprinkler System - Maintenance and Testing Standard
K0354 Sprinkler System - Out of Service Standard
K0355 Portable Fire Extinguishers Standard
K0712 Fire Drills Standard
K0761 Maintenance, Inspection & Testing - Doors Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
K0923 Electrical Equipment ? Ground-Fault Circuit-Interrupter Protection Standard
▼ 55C0001098 Sebastopol Asc Lp 6880 Palm Avenue Sebastopol CA 9 (San Francisco) 06/29/2018 ZJ6Q11 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0240 INFECTION CONTROL Condition
Q0063 ADMINISTRATION OF ANESTHESIA Standard
Q0064 STANDARD LEVEL TAG FOR SURGICAL SERVICES Standard
Q0241 SANITARY ENVIRONMENT Standard
Q0242 INFECTION CONTROL PROGRAM Standard
Q0243 INFECTION CONTROL PROGRAM - DIRECTION Standard
▼ 55C0001104 Advanced Surgical Group, Inc. 2160 Sunset Blvd Rocklin CA 9 (San Francisco) 10/23/2025 1D9716-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0120 MEDICAL STAFF Condition
Q0063 ADMINISTRATION OF ANESTHESIA Standard
Q0064 STANDARD LEVEL TAG FOR SURGICAL SERVICES Standard
Q0121 MEMBERSHIP AND CLINICAL PRIVILEGES Standard
Q0122 REAPPRAISALS Standard