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

Time Interval

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Provider Characteristics

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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
557618 Metro Home Care, Inc 16800 Devonshire St, #205 Granada Hills CA 9 (San Francisco) 02/28/2022 38578-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0572 Plan of care Standard
G0536 A review of all current medications Element
G0574 Plan of care must include the following Element
G0620 Other pertinent instructions Element
G0718 Communication with physicians Element
557619 Fmm Home Care Corporation 4649 Brockton Avenue Riverside CA 9 (San Francisco) 06/29/2023 6021A-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0682 Infection Prevention Standard
G0798 Home health aide assignments and duties Standard
G0536 A review of all current medications Element
G0584 Verbal orders Element
557630 Interim Healthcare Of Northern California 905 Mistletoe Ln. Ste 101 Redding CA 9 (San Francisco) 02/07/2025 6536E-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0572 Plan of care Standard
G0436 Receive all services in plan of care Element
G0514 RN performs assessment Element
G0536 A review of all current medications Element
G0548 Within 48 hours of the patient's return Element
G0590 Promptly alert relevant physician of changes Element
G0608 Coordinate care delivery Element
G0808 Onsite supervisory visit every 14 days Element
557630 Interim Healthcare Of Northern California 905 Mistletoe Ln. Ste 101 Redding CA 9 (San Francisco) 07/28/2022 4F016-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
G0687 COVID-19 Vaccination of Home Health Agency staff Standard
G0484 Document complaint and resolution Element
G0710 Provide services in the plan of care Element
557630 Interim Healthcare Of Northern California 905 Mistletoe Ln. Ste 101 Redding CA 9 (San Francisco) 06/13/2019 1GSK11 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0578 Conformance with physician orders Standard
G0536 A review of all current medications Element
G0574 Plan of care must include the following Element
G0576 All orders recorded in plan of care Element
G0710 Provide services in the plan of care Element
G0716 Preparing clinical notes Element
G0968 Assure implementation of plan of care Element
557636 Lotus Healthcare Partners, Inc. 414 S Prospectors Rd, Suite G Diamond Bar CA 9 (San Francisco) 04/20/2022 3891A-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
G0574 Plan of care must include the following Element
G0576 All orders recorded in plan of care Element
G1014 Interventions and patient response Element
G1022 Discharge and transfer summaries Element
557656 Avance Home Health, Inc 2110 N Winery Fresno CA 9 (San Francisco) 09/16/2024 64177-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0608 Coordinate care delivery Element
557656 Avance Home Health, Inc 2110 N Winery Fresno CA 9 (San Francisco) 04/17/2019 014Z11 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0372 Encoding and transmitting OASIS Standard
G0536 A review of all current medications Element
557664 San Benito Home Health Care 911- C Sunset Drive Hollister CA 9 (San Francisco) 03/04/2022 383DA-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0488 Immediate reporting of abuse by all staff Element
G0536 A review of all current medications Element
G0648 High risk, high volume, or problem-prone area Element
G0948 Responsible for all day-to-day operations Element
557664 San Benito Home Health Care 911- C Sunset Drive Hollister CA 9 (San Francisco) 01/25/2019 B72611 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0586 Review and revision of the plan of care Standard
G0682 Infection Prevention Standard
G0412 Written notice of patient's rights Element
G0536 A review of all current medications Element
G0574 Plan of care must include the following Element
G0580 Only as ordered by a physician Element
G0710 Provide services in the plan of care Element