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 757658 (X3) Date Survey Completed 09/26/2019
Name of Provider or Supplier Accentcare Home Health Of California, Inc. Street Address, City, State 2300 Contra Costa Blvd, Suite 240, Pleasant Hill, 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 reflect the findings of the California Department of Public Health during a recertification survey conducted from 9/23/19 to 9/26/19.



The inspection was limited to the sample selection and does not represent a full inspection of the agency.



Representing the Department : Health Facility Evaluator Nurses (33155 and 38534).



Sample size was seven.


The following reflect the findings of the California Department of Public Health during the investigation of a complaint.



Complaint number: CA00676495



Representing the Department: HFEN 38534



The inspection was limited to the specific complaint investigated and does not represent the findings of a full inspection of the agency.



No deficiencies were issued for complaint number: CA00676495