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
▼ 557597 American Nursing Management & Consulting, Inc. 2105 Beverly Blvd Los Angeles CA 9 (San Francisco) 03/16/2020 SO5111 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0536 A review of all current medications Element
▼ 557603 Tender Care Home Health 317 W Las Tunas Drive #208 San Gabriel CA 9 (San Francisco) 03/17/2023 5F496-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
E0037 EP Training Program Standard
G0642 Program scope Standard
G0682 Infection Prevention Standard
G0412 Written notice of patient's rights Element
G0536 A review of all current medications Element
G0580 Only as ordered by a physician Element
G0610 Patients receive education and training Element
▼ 557603 Tender Care Home Health 317 W Las Tunas Drive #208 San Gabriel CA 9 (San Francisco) 12/10/2019 ZNFR11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
E0017 HHA Comprehensive Assessment in Disaster 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
▼ 557615 All Care Home Health Provider 100 West Broadway Suite 830 Glendale CA 9 (San Francisco) 11/20/2025 1DBA9C-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
G1008 Clinical records Condition
G0572 Plan of care Standard
G0612 Written instructions to patient include: Standard
G1024 Authentication Standard
G0528 Health, psychosocial, functional, cognition Element
G0536 A review of all current medications Element
G0538 Primary caregiver(s), if any Element
G0574 Plan of care must include the following Element
G0588 Reviewed, revised by physician every 60 days Element
G1012 Required items in clinical record Element
G1022 Discharge and transfer summaries Element
▼ 557615 All Care Home Health Provider 100 West Broadway Suite 830 Glendale CA 9 (San Francisco) 09/19/2023 6105A-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0570 Care planning, coordination, quality of care Condition
G0572 Plan of care Standard
G0574 Plan of care must include the following Element
G0580 Only as ordered by a physician 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
▼ 557615 All Care Home Health Provider 100 West Broadway Suite 830 Glendale CA 9 (San Francisco) 06/16/2023 600DA-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0510 Comprehensive Assessment of Patients Condition
G0570 Care planning, coordination, quality of care Condition
G0700 Skilled professional services Condition
E0004 Develop EP Plan, Review and Update Annually Standard
G0544 Update of the comprehensive assessment Standard
G0572 Plan of care Standard
G0682 Infection Prevention Standard
G0536 A review of all current medications Element
G0576 All orders recorded in plan of care Element
G0580 Only as ordered by a physician 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
G0718 Communication with physicians Element
▼ 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