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
▼ 05C0001690 Coastal Surgical Institute 921 Oak Park Blvd Ste 101 Pismo Beach CA 9 (San Francisco) 08/28/2020 BIQG11 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
▼ 05C0001690 Coastal Surgical Institute 921 Oak Park Blvd Ste 101 Pismo Beach CA 9 (San Francisco) 03/12/2019 HABH21 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
E0039 EP Testing Requirements Standard
K0161 Building Construction Type and Height Standard
K0321 Hazardous Areas - Enclosure Standard
K0341 Fire Alarm System - Installation Standard
K0345 Fire Alarm System - Testing and Maintenance Standard
K0353 Sprinkler System - Maintenance and Testing Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
▼ 05C0001690 Coastal Surgical Institute 921 Oak Park Blvd Ste 101 Pismo Beach CA 9 (San Francisco) 01/24/2019 HABH11 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0109 EMERGENCY EQUIPMENT Standard
Q0162 FORM AND CONTENT OF RECORD Standard
Q0229 EXERCISE OF RIGHTS - INFORMED CONSENT Standard
Q0241 SANITARY ENVIRONMENT Standard
▼ 05C0001692 Advanced Ambulatory Surgery Center 1901 Lugonia Ave Suite 100 Redlands CA 9 (San Francisco) 10/18/2018 IODO21 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
E0036 EP Training and Testing Standard
K0293 Exit Signage Standard
K0323 Anesthetizing Locations Standard
K0341 Fire Alarm System - Installation 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
K0521 HVAC Standard
K0712 Fire Drills Standard
K0905 Gas and Vacuum Piped Systems ? Central Supply System Identification and Labeling Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
▼ 05C0001692 Advanced Ambulatory Surgery Center 1901 Lugonia Ave Suite 100 Redlands CA 9 (San Francisco) 08/09/2018 IODO11 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0160 MEDICAL RECORDS Condition
Q0260 PATIENT ADMISSION, ASSESSMENT AND DISCHARGE Condition
Q0162 FORM AND CONTENT OF RECORD Standard
Q0181 ADMINISTRATION OF DRUGS Standard
Q0261 PATIENT ASSESSMENT AND ADMISSION Standard
Q0263 ADMISSION ASSESSMENT - RECORD Standard
Q0266 DISCHARGE - ORDER Standard
▼ 05C0001693 Centinela Valley Endoscopy Center, Inc. 575 East Hardy Street, Suite 101 Inglewood CA 9 (San Francisco) 01/03/2018 L7U021 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
K0291 Emergency Lighting Standard
K0331 Interior Wall and Ceiling Finish Standard
K0751 Draperies, Curtains, and Loosely Hanging Fabrics Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
▼ 05C0001696 Sutter Fairfield Surgery Center 2700 Low Court, 2nd Floor Fairfield CA 9 (San Francisco) 02/21/2024 620FB-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0041 CONTRACT SERVICES Standard
▼ 05C0001696 Sutter Fairfield Surgery Center 2700 Low Court, 2nd Floor Fairfield CA 9 (San Francisco) 03/18/2020 9T8611 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0080 QUALITY ASSESSMENT AND PERFORMANCE Condition
Q0200 LABORATORY AND RADIOLOGIC SERVICES Condition
Q0240 INFECTION CONTROL Condition
Q0041 CONTRACT SERVICES Standard
Q0063 ADMINISTRATION OF ANESTHESIA Standard
Q0083 PERFORMANCE IMPROVEMENT PROJECTS Standard
Q0084 GOVERNING BODY RESPONSIBILITIES Standard
Q0141 ORGANIZATION AND STAFFING Standard
Q0203 RADIOLOGIC SERVICES Standard
Q0204 RADIOLOGIC SERVICES Standard
Q0241 SANITARY ENVIRONMENT Standard
Q0242 INFECTION CONTROL PROGRAM Standard
Q0243 INFECTION CONTROL PROGRAM - DIRECTION Standard
Q0244 INFECTION CONTROL PROGRAM - QAPI Standard
Q0245 INFECTION CONTROL PROGRAM Standard
▼ 05C0001696 Sutter Fairfield Surgery Center 2700 Low Court, 2nd Floor Fairfield CA 9 (San Francisco) 03/09/2020 9T8621 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
E0023 Policies/Procedures for Medical Documentation Standard
E0024 Policies/Procedures-Volunteers and Staffing Standard
E0031 Emergency Officials Contact Information Standard
E0032 Primary/Alternate Means for Communication Standard
E0037 EP Training Program Standard
E0042 Integrated EP Program Standard
K0211 Means of Egress - General Standard
K0223 Doors with Self-Closing Devices Standard
K0291 Emergency Lighting Standard
K0293 Exit Signage Standard
K0345 Fire Alarm System - Testing and Maintenance Standard
K0353 Sprinkler System - Maintenance and Testing Standard
K0511 Utilities - Gas and Electric Standard
K0902 Gas and Vacuum Piped Systems - Other Standard
▼ 05C0001697 Specialty Surgical Center Of Arcadia 51 North Fifth Ave, Suite101 Arcadia CA 9 (San Francisco) 03/01/2019 WMR111 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0040 GOVERNING BODY AND MANAGEMENT Condition
Q0100 ENVIRONMENT Condition
Q0240 INFECTION CONTROL Condition
Q0101 PHYSICAL ENVIRONMENT Standard
Q0141 ORGANIZATION AND STAFFING Standard
Q0181 ADMINISTRATION OF DRUGS Standard
Q0224 ADVANCED DIRECTIVES Standard
Q0241 SANITARY ENVIRONMENT Standard
Q0242 INFECTION CONTROL PROGRAM Standard
Q0261 PATIENT ASSESSMENT AND ADMISSION Standard