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
▼ 557517 Oroville Hospital 1960 Feather River Boulevard Oroville CA 9 (San Francisco) 03/23/2022 38642-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
E0004 Develop EP Plan, Review and Update Annually Standard
G0526 Content of the comprehensive assessment Standard
G0578 Conformance with physician orders Standard
G0682 Infection Prevention Standard
G0702 Services by skilled professionals Standard
G0460 Patient refuses services Element
G0514 RN performs assessment Element
G0548 Within 48 hours of the patient's return Element
G0590 Promptly alert relevant physician of changes Element
G0812 Direct observation every 12 months Element
▼ 557517 Oroville Hospital 1960 Feather River Boulevard Oroville CA 9 (San Francisco) 04/25/2019 6RH811 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0578 Conformance with physician orders Standard
G0514 RN performs assessment Element
G0574 Plan of care must include the following Element
G0710 Provide services in the plan of care Element
G0716 Preparing clinical notes Element
G0968 Assure implementation of plan of care Element
G1012 Required items in clinical record Element
▼ 557550 Practicare Home Health Agency 223 N First Ave, Suite 103 Arcadia CA 9 (San Francisco) 12/16/2022 5E854-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0536 A review of all current medications Element
G0574 Plan of care must include the following Element
G0610 Patients receive education and training Element
G0616 Patient medication schedule/instructions Element
G0714 Patient and caregiver education Element
▼ 557550 Practicare Home Health Agency 223 N First Ave, Suite 103 Arcadia CA 9 (San Francisco) 08/09/2019 QN7U11 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0536 A review of all current medications Element
▼ 557557 Bay Area Care Team Inc. 2505 Taraval Street San Francisco CA 9 (San Francisco) 06/03/2022 4EBC0-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0572 Plan of care Standard
▼ 557559 Agape Home Care, Inc 99 N San Antonio Avenue Suite 360 Upland CA 9 (San Francisco) 02/06/2025 6539C-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0572 Plan of care Standard
G0658 Performance improvement projects Standard
G0952 Ensure that HHA employs qualified personnel Element
▼ 557559 Agape Home Care, Inc 99 N San Antonio Avenue Suite 360 Upland CA 9 (San Francisco) 01/27/2022 382FA-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0682 Infection Prevention Standard
G1060 Licensed Practical (Vocational) Nurse Standard
G0536 A review of all current medications Element
G0576 All orders recorded in plan of care Element
▼ 557559 Agape Home Care, Inc 99 N San Antonio Avenue Suite 360 Upland CA 9 (San Francisco) 01/12/2018 Y04S11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
E0001 Establishment of the Emergency Program (EP) Condition
G0117 COMPLIANCE W/ FED, STATE, LOCAL LAWS Condition
E0006 Plan Based on All Hazards Risk Assessment Standard
E0009 Local, State, Tribal Collaboration Process Standard
E0017 HHA Comprehensive Assessment in Disaster Standard
E0019 Homebound HHA/Hospice Inform EP Officials Standard
E0021 HHA- Procedures for Follow up Staff/Pts. Standard
E0039 EP Testing Requirements Standard
G0118 COMPLIANCE WITH FED, STATE, LOCAL LAWS Standard
G0121 COMPLIANCE W/ ACCEPTED PROFESSIONAL STD Standard
G0236 CLINICAL RECORDS Standard
G0338 UPDATE OF THE COMPREHENSIVE ASSESSMENT Standard
▼ 557561 Western Health Resources 20100 Cedar Road North Sonora CA 9 (San Francisco) 07/19/2022 4F1C5-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0462 Before discharge for cause HHA must: Element
G0466 Make efforts to resolve the problem(s) Element
▼ 557566 Mlh Healthcare, Inc 2555 E Colorado Blvd. Suite 203 Pasadena CA 9 (San Francisco) 01/30/2022 3838B-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
E0004 Develop EP Plan, Review and Update Annually Standard
G0684 Infection control Standard
G0522 Eligibility for Medicare home health benefit Element
G0536 A review of all current medications Element
G0590 Promptly alert relevant physician of changes Element
G0710 Provide services in the plan of care Element
G0714 Patient and caregiver education Element
G0778 Documentation of inservice training Element