S&C QCOR HHA 2567s
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HHAs 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 HHA 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
▼ 557037 Kaiser, Riverside, Home Health Agency (Parent) 1830 California Avenue Corona CA 9 (San Francisco) 01/02/2026 1DFE64-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0488 Immediate reporting of abuse by all staff Element
▼ 557052 Centerwell Certified Healthcare Corp. 4030 Moorpark Avenue, Suite 251 San Jose CA 9 (San Francisco) 12/06/2018 A7EM11 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0682 Infection Prevention Standard
G0536 A review of all current medications Element
G0574 Plan of care must include the following Element
G0582 Influenza and pneumococcal vaccines Element
G0714 Patient and caregiver education Element
▼ 557061 Kaiser Foundation Hospitals 3240 Arden Way Sacramento CA 9 (San Francisco) 05/22/2025 662CC-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0528 Health, psychosocial, functional, cognition Element
▼ 557061 Kaiser Foundation Hospitals 3240 Arden Way Sacramento CA 9 (San Francisco) 07/14/2022 4EF6F-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0572 Plan of care Standard
G0516 Skilled professional performs assessment Element
▼ 557061 Kaiser Foundation Hospitals 3240 Arden Way Sacramento CA 9 (San Francisco) 04/08/2022 2HM511 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0548 Within 48 hours of the patient's return Element
▼ 557061 Kaiser Foundation Hospitals 3240 Arden Way Sacramento CA 9 (San Francisco) 05/20/2021 BGDG11 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0572 Plan of care Standard
▼ 557065 Kaiser Foundation Hospital Home Health - Novato 7200 Redwood Boulevard, Suite 200 Novato CA 9 (San Francisco) 12/06/2018 71HX11 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
E0017 HHA Comprehensive Assessment in Disaster Standard
G0578 Conformance with physician orders Standard
G0708 Development and evaluation of plan of care Element
▼ 557066 Kaiser Foundation Hospital Home Health Agency- Santa Clara 3900 Freedom Circle, Suite 201 Santa Clara CA 9 (San Francisco) 08/31/2023 60AC1-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0848 Compliance with Federal, State, Local Law Condition
G0682 Infection Prevention Standard
G0444 State toll free HH telephone hotline Element
G0582 Influenza and pneumococcal vaccines Element
G0710 Provide services in the plan of care Element
▼ 557066 Kaiser Foundation Hospital Home Health Agency- Santa Clara 3900 Freedom Circle, Suite 201 Santa Clara CA 9 (San Francisco) 04/05/2019 JYBO11 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0536 A review of all current medications Element
▼ 557067 Kaiser Foundation Hospital Home Health - Hayward 30116 Eigenbrodt Union City CA 9 (San Francisco) 06/08/2023 5FFE2-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0578 Conformance with physician orders Standard
G1012 Required items in clinical record Element