S&C QCOR ASC 2567s
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ASCs 2567s
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Time Interval

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Provider Characteristics

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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
▼ 65C0001000 Guam Surgicenter, Llc 633 Governor Carlos Camacho Road, Suite 101 Tamuning GU 9 (San Francisco) 02/08/2019 K7RL21 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
E0009 Local, State, Tribal Collaboration Process Standard
E0024 Policies/Procedures-Volunteers and Staffing Standard
E0026 Roles Under a Waiver Declared by Secretary Standard
E0029 Development of Communication Plan Standard
K0211 Means of Egress - General Standard
K0223 Doors with Self-Closing Devices Standard
K0291 Emergency Lighting Standard
K0321 Hazardous Areas - Enclosure Standard
K0353 Sprinkler System - Maintenance and Testing Standard
K0355 Portable Fire Extinguishers Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
K0923 Electrical Equipment ? Ground-Fault Circuit-Interrupter Protection Standard
▼ 65C0001001 Hafa Adai Specialist Group, Llp Sunflower Villa, 280 Pale San Vitores Tamuning GU 9 (San Francisco) 08/01/2025 1D230B-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
Q0000 Initial Comments - Not a Deficiency Citation Memo
E0013 Development of EP Policies and Procedures Standard
Q0181 ADMINISTRATION OF DRUGS Standard
▼ 65C0001001 Hafa Adai Specialist Group, Llp Sunflower Villa, 280 Pale San Vitores Tamuning GU 9 (San Francisco) 02/08/2019 F76R21 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
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
E0023 Policies/Procedures for Medical Documentation Standard
E0024 Policies/Procedures-Volunteers and Staffing Standard
E0026 Roles Under a Waiver Declared by Secretary Standard
E0029 Development of Communication Plan Standard
E0036 EP Training and Testing Standard
K0131 Multiple Occupancies Standard
K0211 Means of Egress - General Standard
K0223 Doors with Self-Closing Devices Standard
K0321 Hazardous Areas - Enclosure Standard
K0342 Fire Alarm System - Initiation Standard
K0345 Fire Alarm System - Testing and Maintenance Standard
K0353 Sprinkler System - Maintenance and Testing Standard
K0355 Portable Fire Extinguishers Standard
K0712 Fire Drills Standard
K0751 Draperies, Curtains, and Loosely Hanging Fabrics Standard
K0914 Electrical Systems - Maintenance and Testing Standard
K0920 Electrical Equipment ? Power Cords and Extension Cords Standard
K0929 Gas Equipment ? Precautions for Handling Oxygen Standard