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
▼ 05C0001738 Children's Dental Surgery Center 1610 W Edinger Ave Suite C Santa Ana CA 9 (San Francisco) 12/13/2018 G9NU11 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
Q0100 ENVIRONMENT Condition
Q0120 MEDICAL STAFF Condition
Q0140 NURSING SERVICES Condition
Q0180 PHARMACEUTICAL SERVICES Condition
Q0219 PATIENT RIGHTS Condition
Q0240 INFECTION CONTROL Condition
Q0260 PATIENT ADMISSION, ASSESSMENT AND DISCHARGE Condition
Q0002 DEFINITIONS Standard
Q0041 CONTRACT SERVICES Standard
Q0042 HOSPITALIZATION Standard
Q0061 ANESTHETIC RISK AND EVALUATION Standard
Q0081 PROGRAM SCOPE; PROGRAM ACTIVITIES Standard
Q0084 GOVERNING BODY RESPONSIBILITIES Standard
Q0101 PHYSICAL ENVIRONMENT Standard
Q0109 EMERGENCY EQUIPMENT Standard
Q0122 REAPPRAISALS Standard
Q0141 ORGANIZATION AND STAFFING Standard
Q0161 ORGANIZATION Standard
Q0181 ADMINISTRATION OF DRUGS Standard
Q0202 RADIOLOGIC SERVICES Standard
Q0222 NOTICE OF RIGHTS - POSTING Standard
Q0229 EXERCISE OF RIGHTS - INFORMED CONSENT Standard
Q0234 CONFIDENTIALITY OF CLINICAL RECORDS Standard
Q0241 SANITARY ENVIRONMENT Standard
Q0242 INFECTION CONTROL PROGRAM Standard
Q0244 INFECTION CONTROL PROGRAM - QAPI Standard
Q0245 INFECTION CONTROL PROGRAM Standard
Q0261 PATIENT ASSESSMENT AND ADMISSION Standard
Q0264 POST-SURGICAL ASSESSMENT Standard
▼ 05C0001738 Children's Dental Surgery Center 1610 W Edinger Ave Suite C Santa Ana CA 9 (San Francisco) 11/20/2018 G9NU21 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
E0032 Primary/Alternate Means for Communication Standard
E0036 EP Training and Testing Standard
K0223 Doors with Self-Closing Devices Standard
K0291 Emergency Lighting Standard
K0293 Exit Signage Standard
K0345 Fire Alarm System - Testing and Maintenance Standard
K0346 Fire Alarm System - Out of Service Standard
K0511 Utilities - Gas and Electric Standard
K0712 Fire Drills Standard
K0908 Gas and Vacuum Piped Systems ? Central Supply System Alarms Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
▼ 05C0001744 Samaritan Endoscopy Center 15195 National Avenue, Suite 204 Los Gatos CA 9 (San Francisco) 01/16/2020 JO5211 Complaint
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0064 STANDARD LEVEL TAG FOR SURGICAL SERVICES Standard
Q0162 FORM AND CONTENT OF RECORD Standard
▼ 05C0001750 Reagan Street Surgery Center 10904 Reagan Street Los Alamitos CA 9 (San Francisco) 08/13/2025 1D2898-L1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
K0100 General Requirements - Other Standard
K0291 Emergency Lighting Standard
K0325 Alcohol Based Hand Rub Dispenser (ABHR) Standard
K0345 Fire Alarm System - Testing and Maintenance Standard
K0353 Sprinkler System - Maintenance and Testing Standard
K0355 Portable Fire Extinguishers Standard
K0374 Subdivision of Building Spaces ? Smoke Barrier Doors Standard
K0511 Utilities - Gas and Electric Standard
K0914 Electrical Systems - Maintenance and Testing Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
K0921 Electrical Equipment ? Testing and Maintenance Requirements Standard
▼ 05C0001750 Reagan Street Surgery Center 10904 Reagan Street Los Alamitos CA 9 (San Francisco) 08/06/2025 1D2898-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0064 STANDARD LEVEL TAG FOR SURGICAL SERVICES Standard
Q0084 GOVERNING BODY RESPONSIBILITIES Standard
Q0101 PHYSICAL ENVIRONMENT Standard
Q0109 EMERGENCY EQUIPMENT Standard
Q0141 ORGANIZATION AND STAFFING Standard
Q0181 ADMINISTRATION OF DRUGS Standard
Q0201 LABORATORY SERVICES Standard
Q0241 SANITARY ENVIRONMENT Standard
Q0264 POST-SURGICAL ASSESSMENT Standard
Q0267 DISCHARGE WITH RESPONSIBLE ADULT Standard
▼ 05C0001750 Reagan Street Surgery Center 10904 Reagan Street Los Alamitos CA 9 (San Francisco) 05/16/2018 V1XT21 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
K0223 Doors with Self-Closing Devices Standard
K0353 Sprinkler System - Maintenance and Testing Standard
K0914 Electrical Systems - Maintenance and Testing Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
▼ 05C0001750 Reagan Street Surgery Center 10904 Reagan Street Los Alamitos CA 9 (San Francisco) 04/05/2018 V1XT11 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
Q0140 NURSING SERVICES Condition
Q0180 PHARMACEUTICAL SERVICES Condition
Q0240 INFECTION CONTROL Condition
Q0041 CONTRACT SERVICES Standard
Q0081 PROGRAM SCOPE; PROGRAM ACTIVITIES Standard
Q0082 PROGRAM DATA; PROGRAM ACTIVITIES Standard
Q0101 PHYSICIAL ENVIRONMENT Standard
Q0105 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
Q0224 ADVANCED DIRECTIVES Standard
Q0229 EXERCISE OF RIGHTS - INFORMED CONSENT Standard
Q0241 SANITARY ENVIRONMENT Standard
Q0242 INFECTION CONTROL PROGRAM Standard
Q0245 INFECTION CONTROL PROGRAM Standard
Q0261 ADMISSION ASSESSMENT Standard
Q0265 DISCHARGE - SUPPLIES AND INFORMATION Standard
▼ 05C0001752 Conejo Surgical Center 339 S Moorpark Road Thousand Oaks CA 9 (San Francisco) 06/18/2025 65296-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0060 SURGICAL SERVICES Condition
Q0219 PATIENT RIGHTS Condition
Q0064 STANDARD LEVEL TAG FOR SURGICAL SERVICES Standard
Q0229 EXERCISE OF RIGHTS - INFORMED CONSENT Standard
Q0232 SAFETY Standard
▼ 05C0001764 Santa Clarita Surgery Center Lp 26357 Mcbean Parkway, Suite #100 Santa Clarita CA 9 (San Francisco) 03/27/2019 PD7C11 Complaint
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0241 SANITARY ENVIRONMENT Standard
Q0242 INFECTION CONTROL PROGRAM Standard
▼ 05C0001766 Tower Health And Wellness Surgery Center 1801 Colorado Avenue, Suite 140 Turlock CA 9 (San Francisco) 03/05/2018 J2E211 Recertification, Sample Validation
Deficiency Tag Deficiency Description Tag Type
Q0040 GOVERNING BODY AND MANAGEMENT Condition
Q0120 MEDICAL STAFF Condition
Q0180 PHARMACEUTICAL SERVICES Condition
Q0121 MEMBERSHIP AND CLINICAL PRIVILEGES Standard
Q0122 REAPPRAISALS Standard
Q0123 OTHER PRACTITIONERS Standard
Q0181 ADMINISTRATION OF DRUGS Standard