S&C QCOR HHA 2567s
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HHAs 2567s
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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
▼ 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
▼ 557569 Network Providers For Home Health, Inc 5451 La Palma Ave Suite 34 La Palma CA 9 (San Francisco) 11/14/2024 649FE-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
E0023 Policies/Procedures for Medical Documentation Standard
E0024 Policies/Procedures-Volunteers and Staffing Standard
E0030 Names and Contact Information Standard
E0032 Primary/Alternate Means for Communication Standard
E0033 Methods for Sharing Information Standard
E0039 EP Testing Requirements Standard
G0658 Performance improvement projects Standard
G0682 Infection Prevention Standard
G0684 Infection control Standard
G0798 Home health aide assignments and duties Standard
G1024 Authentication Standard
G0520 5 calendar days after start of care Element
G0536 A review of all current medications Element
G0546 Last 5 days of every 60 days unless: Element
G0548 Within 48 hours of the patient's return Element
G0550 At discharge Element
G0588 Reviewed, revised by physician every 60 days Element
G0602 Communication with all physicians Element
G0606 Integrate all services Element
G0614 Visit schedule Element
G0616 Patient medication schedule/instructions Element
G0622 Name/contact information of clinical manager Element
G0710 Provide services in the plan of care Element
G0712 Patient, caregiver, and family counseling Element
G0716 Preparing clinical notes Element
G0800 Services provided by HH aide Element
G0808 Onsite supervisory visit every 14 days Element
G0984 In accordance with current clinical practice Element
▼ 557569 Network Providers For Home Health, Inc 5451 La Palma Ave Suite 34 La Palma CA 9 (San Francisco) 03/01/2022 384E3-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
E0007 EP Program Patient Population Standard
E0021 HHA- Procedures for Follow up Staff/Pts. Standard
E0023 Policies/Procedures for Medical Documentation Standard
E0030 Names and Contact Information Standard
E0031 Emergency Officials Contact Information Standard
E0032 Primary/Alternate Means for Communication Standard
E0034 Information on Occupancy/Needs Standard
E0037 EP Training Program Standard
G0682 Infection Prevention Standard
G0536 A review of all current medications Element
G0574 Plan of care must include the following Element
G0592 Revised plan of care Element
G0710 Provide services in the plan of care Element
G0716 Preparing clinical notes Element
G0726 Nursing services supervised by RN Element
G0800 Services provided by HH aide Element
G0808 Onsite supervisory visit every 14 days Element
G0948 Responsible for all day-to-day operations Element
G1022 Discharge and transfer summaries Element
▼ 557571 Global Home Healthcare Service, Incorporated 221 N San Dimas Ave Suite B San Dimas CA 9 (San Francisco) 03/09/2018 N03T11 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0412 Written notice of patient's rights Element
G0536 A review of all current medications Element
G0576 All orders recorded in plan of care Element
▼ 557597 American Nursing Management & Consulting, Inc. 2105 Beverly Blvd Los Angeles CA 9 (San Francisco) 11/20/2022 5E523-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
G0572 Plan of care Standard
G0600 Coordination of Care Standard
G0522 Eligibility for Medicare home health benefit Element
G0580 Only as ordered by a physician Element
G0610 Patients receive education and training Element
G0766 HHA maintains documentation of training Element