Department of Health & Human Services

Centers for Medicare & Medicaid Services
Form Approved

OMB No. 0938-0391

Statement of Deficiencies (X1) Provider/Supplier/CLIA Identification Number 757375 (X3) Date Survey Completed 07/07/2025
Name of Provider or Supplier Intense Home Health Inc Street Address, City, State 3786 La Crescenta Ave. Suite 104, Glendale, CA
For information on the provider's plan to correct this deficiency, please contact the provider or the state survey agency.
(X4) ID Prefix Tag Summary Statement of Deficiencies

(Each deficiency should be preceded by full regulatory or LSC identifying information)
G0000 The following reflects the findings of the California Department of Public Health during a Complaint Validation Survey.

 

Census: 17

Sample Size: 7

Home Visits: 3

Closed Records: 2