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
▼ 559569 Americano Home Health Care, Inc 10012 Commerce Ave Suite D Tujunga CA 9 (San Francisco) 06/12/2025 66627-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0572 Plan of care Standard
G0412 Written notice of patient's rights Element
G0952 Ensure that HHA employs qualified personnel Element
▼ 559595 Unicorn Home Health, Inc 400 S Glendale Avenue Suite J Glendale CA 9 (San Francisco) 08/28/2023 60DB3-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
E0036 EP Training and Testing Standard
G0536 A review of all current medications Element
G0590 Promptly alert relevant physician of changes Element
G0610 Patients receive education and training Element
G0710 Provide services in the plan of care Element
▼ 559613 Sympathy Home Health Care, Inc 1818 N Orange Grove Ave Suite 202 Pomona CA 9 (San Francisco) 05/02/2024 61AA3-H2 Complaint
Deficiency Tag Deficiency Description Tag Type
G0406 Patient rights Condition
G0940 Organization and administration of services Condition
G1024 Authentication Standard
G0412 Written notice of patient's rights Element
G0418 Patient's or legal representative's signature Element
G0434 Participate in care Element
G0436 Receive all services in plan of care Element
G0444 State toll free HH telephone hotline Element
G0528 Health, psychosocial, functional, cognition Element
G0590 Promptly alert relevant physician of changes Element
G0602 Communication with all physicians Element
G0610 Patients receive education and training Element
G0966 Assure patient needs are continually assessed Element
G0984 In accordance with current clinical practice Element
▼ 559613 Sympathy Home Health Care, Inc 1818 N Orange Grove Ave Suite 202 Pomona CA 9 (San Francisco) 12/08/2023 61AA3-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0510 Comprehensive Assessment of Patients Condition
G0570 Care planning, coordination, quality of care Condition
G0640 Quality assessment/performance improvement Condition
G0700 Skilled professional services Condition
G1008 Clinical records Condition
G0572 Plan of care Standard
G0644 Program data Standard
G0658 Performance improvement projects Standard
G1010 Contents of clinical record Standard
G0520 5 calendar days after start of care Element
G0536 A review of all current medications Element
G0588 Reviewed, revised by physician every 60 days Element
G0706 Interdisciplinary assessment of the patient Element
G0726 Nursing services supervised by RN Element
G0948 Responsible for all day-to-day operations Element
G0978 Must have a written agreement Element
G1012 Required items in clinical record Element
▼ 559617 Valeri Home Health, Inc. 8622 Reseda Blvd Ste 214 Northridge CA 9 (San Francisco) 05/17/2024 63141-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0570 Care planning, coordination, quality of care Condition
G1008 Clinical records Condition
G0572 Plan of care Standard
G0612 Written instructions to patient include: Standard
G0436 Receive all services in plan of care Element
G0458 Outcomes/goals have been achieved Element
G0536 A review of all current medications Element
G0584 Verbal orders Element
G0588 Reviewed, revised by physician every 60 days Element
G0592 Revised plan of care Element
G0598 Discharge plans communication Element
G0602 Communication with all physicians Element
G0616 Patient medication schedule/instructions Element
G0952 Ensure that HHA employs qualified personnel Element
G1012 Required items in clinical record Element
G1022 Discharge and transfer summaries Element
▼ 559632 Prospect Home Healthcare, Inc. 7120 Hayvenhurst Ave Suite 206 Van Nuys CA 9 (San Francisco) 08/23/2024 63F35-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0406 Condition of Participation: Patient rights. Condition
G0510 Comprehensive Assessment of Patients Condition
G0940 Organization and administration of services Condition
G1008 Clinical records Condition
G0942 Governing body Standard
G1028 Protection of records Standard
G0412 Written notice of patient's rights Element
G0550 At discharge Element
G1012 Required items in clinical record Element
G1022 Discharge and transfer summaries Element
▼ 559679 Sima Corporate Group 10700 Jersey Blvd. Suite 300 Rancho Cucamonga CA 9 (San Francisco) 11/21/2024 64AD8-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0640 Quality assessment/performance improvement Condition
G0642 Program scope Standard
G0644 Program data Standard
G0658 Performance improvement projects Standard
G0660 Executive responsibilities for QAPI Standard
G0410 Information to patient Element
G0514 RN performs assessment Element
G0520 5 calendar days after start of care Element
G0726 Nursing services supervised by RN Element
G1022 Discharge and transfer summaries Element
▼ 559686 Apollo Home Health Care Inc 14081 S. Yorba St. Tustin CA 9 (San Francisco) 01/07/2026 1DFCC2-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G1024 Authentication Standard
G0444 State toll free HH telephone hotline Element
G0536 A review of all current medications Element
G0546 Last 5 days of every 60 days unless: Element
G0574 Plan of care must include the following Element
G0584 Verbal orders Element
G0588 Reviewed, revised by physician every 60 days Element
G0602 Communication with all physicians Element
G0614 Visit schedule Element
G0710 Provide services in the plan of care Element
G0800 Services provided by HH aide Element
G0984 In accordance with current clinical practice Element
▼ 559686 Apollo Home Health Care Inc 14081 S. Yorba St. Tustin CA 9 (San Francisco) 09/19/2025 1D746D-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0572 Plan of care Standard
G0948 Responsible for all day-to-day operations Element
G1012 Required items in clinical record Element
▼ 559720 Happy Life Home Health Care, Inc 517 E Wilson Ave Suite 105 Glendale CA 9 (San Francisco) 11/15/2024 62BD0-H3 Complaint
Deficiency Tag Deficiency Description Tag Type
G0592 Revised plan of care Element
G0610 Patients receive education and training Element