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
▼ 05C0001668 Pacific Surgery Center Of Ventura 3805 Telegraph Rd Ventura CA 9 (San Francisco) 03/28/2025 64FA4-H1 Recertification
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
Q0160 MEDICAL RECORDS Condition
Q0180 PHARMACEUTICAL SERVICES Condition
Q0240 INFECTION CONTROL Condition
Q0062 ANESTHETIC - DISCHARGE Standard
Q0063 ADMINISTRATION OF ANESTHESIA 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
Q0109 EMERGENCY EQUIPMENT Standard
Q0121 MEMBERSHIP AND CLINICAL PRIVILEGES Standard
Q0123 OTHER PRACTITIONERS Standard
Q0141 ORGANIZATION AND STAFFING Standard
Q0162 FORM AND CONTENT OF RECORD Standard
Q0181 ADMINISTRATION OF DRUGS Standard
Q0241 SANITARY ENVIRONMENT Standard
▼ 05C0001671 Specialty Surgical Center Of Irvine 15825 Laguna Canyon Rd, Suite 200 Irvine CA 9 (San Francisco) 08/27/2019 CPHO21 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
E0009 Local, State, Tribal Collaboration Process Standard
E0018 Procedures for Tracking of Staff and Patients Standard
E0023 Policies/Procedures for Medical Documentation Standard
E0026 Roles Under a Waiver Declared by Secretary Standard
E0031 Emergency Officials Contact Information Standard
E0033 Methods for Sharing Information Standard
E0037 EP Training Program Standard
E0039 EP Testing Requirements Standard
K0131 Multiple Occupancies Standard
K0211 Means of Egress - General Standard
K0293 Exit Signage Standard
K0345 Fire Alarm System - Testing and Maintenance Standard
K0353 Sprinkler System - Maintenance and Testing Standard
K0355 Portable Fire Extinguishers Standard
K0372 Subdivision of Building Spaces ? Smoke Barrier Construction Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
▼ 05C0001671 Specialty Surgical Center Of Irvine 15825 Laguna Canyon Rd, Suite 200 Irvine CA 9 (San Francisco) 08/05/2019 CPHO11 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0040 GOVERNING BODY AND MANAGEMENT Condition
Q0160 MEDICAL RECORDS Condition
Q0240 INFECTION CONTROL Condition
Q0061 ANESTHETIC RISK AND EVALUATION Standard
Q0064 STANDARD LEVEL TAG FOR SURGICAL SERVICES Standard
Q0081 PROGRAM SCOPE; PROGRAM ACTIVITIES Standard
Q0109 EMERGENCY EQUIPMENT Standard
Q0122 REAPPRAISALS Standard
Q0141 ORGANIZATION AND STAFFING Standard
Q0162 FORM AND CONTENT OF RECORD Standard
Q0181 ADMINISTRATION OF DRUGS Standard
Q0203 RADIOLOGIC SERVICES Standard
Q0241 SANITARY ENVIRONMENT Standard
Q0242 INFECTION CONTROL PROGRAM Standard
Q0261 PATIENT ASSESSMENT AND ADMISSION Standard
Q0262 ADMISSION AND PRE-SURGICAL ASSESSMENT Standard
Q0265 DISCHARGE - SUPPLIES AND INFORMATION Standard
▼ 05C0001672 Newport Plaza Surgical Center 1901 Newport Blvd Suite 120w Costa Mesa CA 9 (San Francisco) 05/01/2025 65F71-L1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
K0161 Building Construction Type and Height Standard
K0345 Fire Alarm System - Testing and Maintenance Standard
K0353 Sprinkler System - Maintenance and Testing Standard
▼ 05C0001672 Newport Plaza Surgical Center 1901 Newport Blvd Suite 120w Costa Mesa CA 9 (San Francisco) 04/29/2025 65F71-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0041 CONTRACT SERVICES Standard
Q0042 HOSPITALIZATION Standard
Q0101 PHYSICAL ENVIRONMENT Standard
Q0121 MEMBERSHIP AND CLINICAL PRIVILEGES Standard
Q0141 ORGANIZATION AND STAFFING Standard
Q0229 EXERCISE OF RIGHTS - INFORMED CONSENT Standard
Q0234 CONFIDENTIALITY OF CLINICAL RECORDS Standard
Q0241 SANITARY ENVIRONMENT Standard
Q0242 INFECTION CONTROL PROGRAM Standard
Q0261 PATIENT ASSESSMENT AND ADMISSION Standard
Q0262 ADMISSION AND PRE-SURGICAL ASSESSMENT Standard
▼ 05C0001672 Newport Plaza Surgical Center 1901 Newport Blvd Suite 120w Costa Mesa CA 9 (San Francisco) 02/01/2018 13RJ21 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
E0029 Development of Communication Plan Standard
K0345 Fire Alarm System - Testing and Maintenance Standard
K0353 Sprinkler System - Maintenance and Testing Standard
K0371 Subdivision of Building Spaces ? Smoke Compartments Standard
K0374 Subdivision of Building Spaces ? Smoke Barrier Doors Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
▼ 05C0001673 Glendora Digestive Disease Institute 1794 S Barranca Avenue Glendora CA 9 (San Francisco) 09/09/2025 1D66A0-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0264 POST-SURGICAL ASSESSMENT Standard
▼ 05C0001673 Glendora Digestive Disease Institute 1794 S Barranca Avenue Glendora CA 9 (San Francisco) 09/17/2019 MNGI11 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0041 CONTRACT SERVICES Standard
Q0109 EMERGENCY EQUIPMENT Standard
Q0162 FORM AND CONTENT OF RECORD Standard
Q0181 ADMINISTRATION OF DRUGS Standard
Q0229 EXERCISE OF RIGHTS - INFORMED CONSENT Standard
Q0233 SAFETY - ABUSE/HARASSMENT Standard
Q0241 SANITARY ENVIRONMENT Standard
Q0242 INFECTION CONTROL PROGRAM Standard
Q0265 DISCHARGE - SUPPLIES AND INFORMATION Standard
Q0266 DISCHARGE - ORDER Standard
Q0267 DISCHARGE WITH RESPONSIBLE ADULT Standard
▼ 05C0001683 United Surgery Center - Irvine 15825 Laguna Canyon Rd Suite 100 Irvine CA 9 (San Francisco) 05/09/2018 AT2Z21 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
E0013 Development of EP Policies and Procedures Standard
E0029 Development of Communication Plan Standard
E0036 EP Training and Testing Standard
K0131 Multiple Occupancies Standard
K0211 Means of Egress - General Standard
K0291 Emergency Lighting Standard
K0325 Alcohol Based Hand Rub Dispenser (ABHR) Standard
K0353 Sprinkler System - Maintenance and Testing Standard
K0521 HVAC Standard
K0781 Portable Space Heaters Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
▼ 05C0001683 United Surgery Center - Irvine 15825 Laguna Canyon Rd Suite 100 Irvine CA 9 (San Francisco) 03/22/2018 AT2Z11 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0040 GOVERNING BODY AND MANAGEMENT Condition
Q0060 SURGICAL SERVICES Condition
Q0140 NURSING SERVICES Condition
Q0240 INFECTION CONTROL Condition
Q0260 PATIENT ADMISSION, ASSESSMENT AND DISCHARGE Condition
Q0042 HOSPITALIZATION Standard
Q0061 ANESTHETIC RISK AND EVALUATION Standard
Q0062 ANESTHETIC - DISCHARGE Standard
Q0064 STANDARD LEVEL TAG FOR SURGICAL SERVICES Standard
Q0081 PROGRAM SCOPE; PROGRAM ACTIVITIES Standard
Q0082 PROGRAM DATA; PROGRAM ACTIVITIES 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
Q0161 ORGANIZATION Standard
Q0162 FORM AND CONTENT OF RECORD Standard
Q0181 ADMINISTRATION OF DRUGS Standard
Q0202 RADIOLOGIC SERVICES Standard
Q0221 NOTICE OF RIGHTS Standard
Q0224 ADVANCED DIRECTIVES Standard
Q0229 EXERCISE OF RIGHTS - INFORMED CONSENT Standard
Q0241 SANITARY ENVIRONMENT Standard
Q0242 INFECTION CONTROL PROGRAM Standard
Q0244 INFECTION CONTROL PROGRAM - QAPI Standard
Q0261 ADMISSION ASSESSMENT Standard
Q0262 PRE-SURGICAL ASSESSMENT Standard
Q0265 DISCHARGE - SUPPLIES AND INFORMATION Standard
Q0266 DISCHARGE - ORDER Standard