S&C QCOR ESRD 2567s
d QCOR:  Quality, Certification and Oversight Reports.
ESRDs 2567s
Selection Criteria

Time Interval

Please select the calendar year or years for which you would like data.

Note: There is currently no ESRD 2567 data available past Feb 19, 2026 due to data system migrations.

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 ESRD 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
552770 Desert Cities Dialysis - Amethyst 11883 Amethyst Road Victorville CA 9 (San Francisco) 03/02/2018 LN3G11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
E0003 Establishment Of The Ep Program Dialysis Condition
E0004 Develop Ep Plan, Review And Update Annually Standard
V0000 Initial Comments - Not A Deficiency Citation Memo
V0110 Cfc - Infection Control Condition
V0115 Ic - Wear Gowns, Shields/Masks; Staff Not Eat/Drink In Tx Area Standard
V0116 Ic - Items Taken To Station Disposed/Dedicated Or Disinfected Standard
V0119 Ic - Supply Cart Distant/No Supplies In Pockets Standard
V0124 Ic - Hbv - Test All Pts, Review Results/Pt Status Known Preadmit Standard
V0126 Ic - Hbv - Vaccinate Patients & Staff Standard
V0196 Carbon Adsorption - Monitoring, Testing Frequency Standard
V0243 Bicarb Jugs Rinsed Daily/Stored Dry Standard
V0400 Cfc - Physical Environment Condition
V0401 Pe - Safe, Functional, Comfortable Environment Standard
V0500 Cfc - Patient Assessment Condition
V0503 Appropriateness Of Dialysis Rx Standard
V0504 Assess B/P & Fluid Management Needs Standard
V0625 Cfc - Quality Assessment & Performance Improvement Condition
V0627 Ongoing, Uses Indicators - Improved Health Outcomes Standard
552770 Desert Cities Dialysis - Amethyst 11883 Amethyst Road Victorville CA 9 (San Francisco) 03/15/2019 YE0I11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0112 Ic - Cdc Mmwr 2001 Standard
V0143 Ic - Aseptic Techniques For Iv Meds Standard
V0260 Personnel - Training Program/Periodic Audits Standard
V0562 Patient/Family Education & Training Standard
V0676 Clia Labs/Meet Needs Of Patients Standard
552770 Desert Cities Dialysis - Amethyst 11883 Amethyst Road Victorville CA 9 (San Francisco) 10/06/2021 TYY611 Complaint
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0685 Self Care/Home Training Nurse - 12 Mo Rn + 3 Mo Modality Standard
552771 Roseville Dialysis 1836 Sierra Gardens Drive Roseville CA 9 (San Francisco) 03/21/2019 DQ0911 Standard
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0503 Appropriateness Of Dialysis Rx Standard
552772 Walnut Creek West Dialysis 1221 Rossmoor Parkway Walnut Creek CA 9 (San Francisco) 09/28/2018 S1RJ11 Complaint
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0115 Ic - Wear Gowns, Shields/Masks; Staff Not Eat/Drink In Tx Area Standard
V0122 Ic - Clean, Disinfect Surfaces & Equipment/Written Protocols Standard
552772 Walnut Creek West Dialysis 1221 Rossmoor Parkway Walnut Creek CA 9 (San Francisco) 09/26/2019 RXJE11 Complaint, Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
E0028 Dialysis Emergency Equipment Standard
E0038 Esrd Ep Training Program Standard
V0000 Initial Comments - Not A Deficiency Citation Memo
V0110 Cfc - Infection Control Condition
V0112 Ic - Cdc Mmwr 2001 Standard
V0113 Ic - Wear Gloves/Hand Hygiene Standard
V0115 Ic - Wear Gowns, Shields/Masks; Staff Not Eat/Drink In Tx Area Standard
V0120 Ic - Transducer Protectors: Not Wetted/Changed Standard
V0122 Ic - Clean, Disinfect Surfaces & Equipment/Written Protocols Standard
V0126 Ic - Hbv - Vaccinate Patients & Staff Standard
V0132 Ic - Training And Education Standard
V0147 Ic - Staff Education Re Catheters/Catheter Care Standard
V0407 Pe - Hemodialysis Patients In View During Treatments Standard
V0715 Md Resp - Ensure All Adhere To P&P Standard
552773 Bluff Rd Dialysis 100 West Washington Boulevard Montebello CA 9 (San Francisco) 11/13/2019 Y0G011 Standard
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0113 Ic - Wear Gloves/Hand Hygiene Standard
V0115 Ic - Wear Gowns, Shields/Masks; Staff Not Eat/Drink In Tx Area Standard
V0120 Ic - Transducer Protectors: Not Wetted/Changed Standard
V0176 Water Purity - Ansi/Aami Rd52-2004 Standard
V0184 Environment: Secure And Restricted Standard
V0236 Additives - Labeling Spiked Jugs/Labeling If For Specific Pt Standard
V0403 Pe - Equipment Maintenance - Manufacturer'S Dfu Standard
V0501 Patient Assessment - Interdisciplinary Team Mbrs/Resp. Standard
V0503 Appropriateness Of Dialysis Rx Standard
V0516 Frequency - Initial: 30 Days/13 Tx Standard
V0517 F/U Reassessment - Within 3 Months Of Initial Standard
V0519 Frequency Reassessment - Stable - Annual Standard
V0557 Initial Poc Implemented - 30 Days/13 Tx Standard
V0558 Implement Updates Of Poc - 15 Days P Pt Assessment Standard
V0715 Md Resp - Ensure All Adhere To P&P Standard
V0726 Medical Records - Complete, Accurate, Accessible Standard
552774 Pomona Valley Dialysis 2703 S Towne Ave Pomona CA 9 (San Francisco) 07/25/2018 331J11 Standard
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0113 Ic - Wear Gloves/Hand Hygiene Standard
V0120 Ic - Transducer Protectors: Not Wetted/Changed Standard
V0122 Ic - Clean, Disinfect Surfaces & Equipment/Written Protocols Standard
V0196 Carbon Adsorption - Monitoring, Testing Frequency Standard
V0231 Acid Conc Mixing Sys - Empty Completely//Prevent Corrosion Standard
V0403 Pe - Equipment Maintenance - Manufacturer'S Dfu Standard
V0501 Patient Assessment - Interdisciplinary Team Mbrs/Resp. Standard
V0503 Appropriateness Of Dialysis Rx Standard
V0517 F/U Reassessment - Within 3 Months Of Initial Standard
V0520 Frequency Reassessment - Unstable - Monthly Standard
V0557 Initial Poc Implemented - 30 Days/13 Tx Standard
V0558 Implement Updates Of Poc - 15 Days P Pt Assessment Standard
552775 Fresenius Medical Care Santa Ana Dialysis 2740 South Bristol St, Suite 110 Santa Ana CA 9 (San Francisco) 11/28/2018 53R611 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
E0038 Esrd Ep Training Program Standard
V0000 Initial Comments - Not A Deficiency Citation Memo
V0403 Pe - Equipment Maintenance - Manufacturer'S Dfu Standard
V0544 Achieve Adequate Clearance Standard
V0715 Md Resp - Ensure All Adhere To P&P Standard
552775 Fresenius Medical Care Santa Ana Dialysis 2740 South Bristol St, Suite 110 Santa Ana CA 9 (San Francisco) 04/09/2025 XPRP11 Complaint
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0503 Appropriateness Of Dialysis Rx Standard
V0504 Assess B/P & Fluid Management Needs Standard