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
▼ 559720 Happy Life Home Health Care, Inc 517 E Wilson Ave Suite 105 Glendale CA 9 (San Francisco) 09/14/2024 62BD0-H2 Complaint
Deficiency Tag Deficiency Description Tag Type
G0510 Comprehensive Assessment of Patients Condition
G0700 Skilled professional services Condition
G0580 Only as ordered by a physician Element
G0706 Interdisciplinary assessment of the patient Element
G0710 Provide services in the plan of care Element
▼ 559720 Happy Life Home Health Care, Inc 517 E Wilson Ave Suite 105 Glendale CA 9 (San Francisco) 04/12/2024 62BD0-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0406 Condition of Participation: Patient rights. Condition
G0570 Care planning, coordination, quality of care Condition
G1008 Clinical records Condition
G0572 Plan of care Standard
G0612 Written instructions to patient include: Standard
G1028 Protection of records Standard
G0434 Participate in care Element
G0438 Have a confidential clinical record Element
G0444 State toll free HH telephone hotline Element
G0446 Contact info Federal/State-funded entities Element
G0536 A review of all current medications Element
G0550 At discharge Element
G0574 Plan of care must include the following Element
G0576 All orders recorded in plan of care Element
G0590 Promptly alert relevant physician of changes Element
G0606 Integrate all services Element
G0614 Visit schedule Element
G0948 Responsible for all day-to-day operations Element
G0978 Must have a written agreement Element
G1012 Required items in clinical record Element
▼ 559751 Valley View Healthcare Services Llc 120 Independence Circle Suite G Chico CA 9 (San Francisco) 04/15/2026 22DEF3-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0514 RN performs assessment Element
G0590 Promptly alert relevant physician of changes Element
G0710 Provide services in the plan of care Element
▼ 657004 Gurusamy Inc. 809 Chalan Pasaheru, Unit 2 Barrigada GU 9 (San Francisco) 09/15/2023 611E9-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0570 Care planning, coordination, quality of care Condition
G0578 Conformance with physician orders Standard
G0576 All orders recorded in plan of care Element
▼ 657004 Gurusamy Inc. 809 Chalan Pasaheru, Unit 2 Barrigada GU 9 (San Francisco) 05/01/2019 2SVR11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0680 Infection prevention and control Condition
G0572 Plan of care Standard
G0682 Infection Prevention Standard
G0576 All orders recorded in plan of care Element
▼ 657005 Takecare Insurance Company, Inc. 548 South Marine Corps Drive Tamuning GU 9 (San Francisco) 06/10/2026 2339F2-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
G0580 Only as ordered by a physician Element
▼ 657005 Takecare Insurance Company, Inc. 548 South Marine Corps Drive Tamuning GU 9 (San Francisco) 09/23/2022 4F45C-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0574 Plan of care must include the following Element
▼ 657005 Takecare Insurance Company, Inc. 548 South Marine Corps Drive Tamuning GU 9 (San Francisco) 01/30/2019 B3YH11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0942 Governing body Standard
G0584 Verbal orders Element
G0590 Promptly alert relevant physician of changes Element
G0592 Revised plan of care Element
G0602 Communication with all physicians Element
▼ 673101 Presidente Home Care Inc. 405 N Main Street Suite 1 Mcallen TX 6 (Dallas) 05/22/2025 662F1-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0372 Encoding and transmitting OASIS Standard
▼ 673101 Presidente Home Care Inc. 405 N Main Street Suite 1 Mcallen TX 6 (Dallas) 06/17/2022 4ED6D-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
G0574 Plan of care must include the following Element
G0580 Only as ordered by a physician Element