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
▼ 05C0001766 Tower Health And Wellness Surgery Center 1801 Colorado Avenue, Suite 140 Turlock CA 9 (San Francisco) 02/21/2018 J2E221 Recertification, Sample Validation
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
K0291 Emergency Lighting Standard
K0355 Portable Fire Extinguishers Standard
K0914 Electrical Systems - Maintenance and Testing Standard
K0919 Electrical Equipment - Other Standard
▼ 05C0001767 Mission Hills Pain Treatment Center 25982 Pala, Suite 280 Mission Viejo CA 9 (San Francisco) 12/10/2024 64B40-L1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
E0039 EP Testing Requirements Standard
K0345 Fire Alarm System - Testing and Maintenance Standard
K0353 Sprinkler System - Maintenance and Testing Standard
K0712 Fire Drills Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
▼ 05C0001767 Mission Hills Pain Treatment Center 25982 Pala, Suite 280 Mission Viejo CA 9 (San Francisco) 12/05/2024 64B40-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0041 CONTRACT SERVICES Standard
Q0042 HOSPITALIZATION Standard
Q0081 PROGRAM SCOPE; PROGRAM ACTIVITIES Standard
Q0084 GOVERNING BODY RESPONSIBILITIES Standard
Q0162 FORM AND CONTENT OF RECORD Standard
Q0181 ADMINISTRATION OF DRUGS Standard
Q0241 SANITARY ENVIRONMENT Standard
Q0242 INFECTION CONTROL PROGRAM Standard
Q0244 INFECTION CONTROL PROGRAM - QAPI Standard
Q0263 ADMISSION ASSESSMENT - RECORD Standard
▼ 05C0001770 Vallarine Dental, Llc 2828 Fresno Street, Suite 100 Fresno CA 9 (San Francisco) 07/25/2019 B8RP21 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
E0024 Policies/Procedures-Volunteers and Staffing Standard
E0039 EP Testing Requirements Standard
K0161 Building Construction Type and Height Standard
K0211 Means of Egress - General Standard
K0353 Sprinkler System - Maintenance and Testing Standard
K0354 Sprinkler System - Out of Service Standard
K0712 Fire Drills Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
K0920 Electrical Equipment ? Power Cords and Extension Cords Standard
▼ 05C0001770 Vallarine Dental, Llc 2828 Fresno Street, Suite 100 Fresno CA 9 (San Francisco) 06/26/2019 B8RP11 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0141 ORGANIZATION AND STAFFING Standard
Q0242 INFECTION CONTROL PROGRAM Standard
Q0261 PATIENT ASSESSMENT AND ADMISSION Standard
▼ 05C0001771 Natraj Surgery Center, Inc 555 West Putnam Avenue Porterville CA 9 (San Francisco) 11/10/2020 10YH11 Complaint
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0245 INFECTION CONTROL PROGRAM Standard
▼ 05C0001771 Natraj Surgery Center, Inc 555 West Putnam Avenue Porterville CA 9 (San Francisco) 08/13/2019 SFD411 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0061 ANESTHETIC RISK AND EVALUATION Standard
Q0084 GOVERNING BODY RESPONSIBILITIES Standard
Q0141 ORGANIZATION AND STAFFING Standard
Q0181 ADMINISTRATION OF DRUGS Standard
Q0229 EXERCISE OF RIGHTS - INFORMED CONSENT Standard
Q0241 SANITARY ENVIRONMENT Standard
Q0242 INFECTION CONTROL PROGRAM Standard
Q0245 INFECTION CONTROL PROGRAM Standard
▼ 05C0001771 Natraj Surgery Center, Inc 555 West Putnam Avenue Porterville CA 9 (San Francisco) 07/11/2019 SFD421 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
E0018 Procedures for Tracking of Staff and Patients Standard
E0024 Policies/Procedures-Volunteers and Staffing Standard
E0026 Roles Under a Waiver Declared by Secretary Standard
E0039 EP Testing Requirements 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
K0712 Fire Drills Standard
K0914 Electrical Systems - Maintenance and Testing Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
▼ 05C0001777 Salida Surgery Center 5712 Pirrone Road Salida CA 9 (San Francisco) 06/25/2019 6AHP21 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
E0018 Procedures for Tracking of Staff and Patients Standard
E0020 Policies for Evac. and Primary/Alt. Comm. Standard
K0161 Building Construction Type and Height Standard
K0321 Hazardous Areas - Enclosure 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
K0912 Electrical Systems - Receptacles Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
K0919 Electrical Equipment - Other Standard
K0920 Electrical Equipment ? Power Cords and Extension Cords Standard
K0923 Electrical Equipment ? Ground-Fault Circuit-Interrupter Protection Standard
▼ 05C0001777 Salida Surgery Center 5712 Pirrone Road Salida CA 9 (San Francisco) 06/12/2019 6AHP11 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
Q0240 INFECTION CONTROL Condition
Q0061 ANESTHETIC RISK AND EVALUATION Standard
Q0064 STANDARD LEVEL TAG FOR SURGICAL SERVICES Standard
Q0082 PROGRAM DATA; PROGRAM ACTIVITIES Standard
Q0101 PHYSICAL ENVIRONMENT Standard
Q0122 REAPPRAISALS Standard
Q0141 ORGANIZATION AND STAFFING Standard
Q0162 FORM AND CONTENT OF RECORD Standard
Q0223 NOTICE - PHYSICIAN OWNERSHIP Standard
Q0241 SANITARY ENVIRONMENT Standard
Q0242 INFECTION CONTROL PROGRAM Standard
Q0244 INFECTION CONTROL PROGRAM - QAPI Standard
Q0261 PATIENT ASSESSMENT AND ADMISSION Standard