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
▼ 557084 Rady's Children Hospital-San Diego 8291 Aero Place, Suite 130 San Diego CA 9 (San Francisco) 02/07/2019 HF3P11 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0514 RN performs assessment Element
▼ 557089 Assisted Home Care, Inc 10550 Sepulveda Blvd Suite 116 Mission Hills CA 9 (San Francisco) 01/14/2022 38214-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0512 Standard: Initial assessment visit. Standard
G1010 Contents of clinical record Standard
G0514 RN performs assessment Element
G0574 Plan of care must include the following Element
G0602 Communication with all physicians Element
▼ 557094 Adventist Health Home Care 5500 Ming Ave., Ste. 128 Bakersfield CA 9 (San Francisco) 04/04/2019 JE0D11 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
G0536 A review of all current medications Element
G0610 Patients receive education and training Element
G0710 Provide services in the plan of care Element
G0718 Communication with physicians Element
G0800 Services provided by HH aide Element
G1022 Discharge and transfer summaries Element
▼ 557106 Uhs Corona, Inc. 730 Magnolia Ave Corona CA 9 (San Francisco) 06/09/2022 4EC70-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0536 A review of all current medications Element
G0984 In accordance with current clinical practice Element
▼ 557106 Uhs Corona, Inc. 730 Magnolia Ave Corona CA 9 (San Francisco) 06/13/2018 15D111 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0942 Governing body Standard
G0536 A review of all current medications Element
G0580 Only as ordered by a physician Element
G0710 Provide services in the plan of care Element
G0718 Communication with physicians Element
G0984 In accordance with current clinical practice Element
G1012 Required items in clinical record Element
▼ 557107 Medical Home Care Professionals 2115 Churn Creek Rd Redding CA 9 (San Francisco) 02/23/2024 62372-H1 Complaint, Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0512 Standard: Initial assessment visit. Standard
G0578 Conformance with physician orders Standard
G0684 Infection control Standard
G0536 A review of all current medications Element
G0574 Plan of care must include the following Element
G0718 Communication with physicians Element
▼ 557107 Medical Home Care Professionals 2115 Churn Creek Rd Redding CA 9 (San Francisco) 10/30/2019 NUF411 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
G0536 A review of all current medications Element
G0574 Plan of care must include the following Element
G0604 Integrate all orders Element
G0716 Preparing clinical notes Element
G0800 Services provided by HH aide Element
▼ 557116 Tender Loving Care Health Care Services Western, Llc 1350 Bayshore Hwy, Suite 777 Burlingame CA 9 (San Francisco) 01/22/2018 YJSV11 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0578 Conformance with physician orders Standard
G1010 Contents of clinical record Standard
G0444 State toll free HH telephone hotline Element
G0946 Administrator appointed by governing body Element
G0962 Coordinate patient care Element
▼ 557145 Affiliated Home Health Services, Inc. 240 S Jackson St Suite 210 Glendale CA 9 (San Francisco) 07/11/2019 B2CL11 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0574 Plan of care must include the following Element
▼ 557171 Interim Healthcare 1521 N Carpenter Road, Suite D1 Modesto CA 9 (San Francisco) 09/11/2023 60D07-H1 Complaint, Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0704 Responsibilities of skilled professionals Standard
G0536 A review of all current medications Element
G0608 Coordinate care delivery Element