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
▼ 559003 Elite Health Care Services, Llc 9267 Greenback Ln., Suite B-1 Orangevale CA 9 (San Francisco) 07/16/2026 25D175-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
G1012 Required items in clinical record Element
▼ 559003 Elite Health Care Services, Llc 9267 Greenback Ln., Suite B-1 Orangevale CA 9 (San Francisco) 05/18/2023 5FB7F-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
G0536 A review of all current medications Element
▼ 559016 Sycamore Grove Healthcare Llc 5479 N. Fresno St., Ste. 102 Fresno CA 9 (San Francisco) 09/16/2025 1D63E1-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0682 Infection Prevention Standard
G0704 Responsibilities of skilled professionals Standard
G0602 Communication with all physicians Element
G1014 Interventions and patient response Element
▼ 559031 Health Is Wealth Home Health Agency Llc 3135 Clayton Road Suite 101 Concord CA 9 (San Francisco) 05/17/2024 5F71B-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0436 Receive all services in plan of care Element
G0574 Plan of care must include the following Element
G1012 Required items in clinical record Element
▼ 559050 Hand In Heart Home Health Inc 5450 Ralston Street, Unit 202 Ventura CA 9 (San Francisco) 05/20/2024 62ECD-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0570 Care planning, coordination, quality of care Condition
G0940 Organization and administration of services Condition
G1008 Clinical records Condition
G0572 Plan of care Standard
G0612 Written instructions to patient include: Standard
G0942 Governing body Standard
G1028 Protection of records Standard
G0460 Patient refuses services Element
G0472 Death of patient Element
G0576 All orders recorded in plan of care Element
G0584 Verbal orders Element
G0614 Visit schedule Element
G0952 Ensure that HHA employs qualified personnel Element
G0954 Ensures qualified pre-designated person Element
G0962 Coordinate patient care Element
G1012 Required items in clinical record Element
G1022 Discharge and transfer summaries Element
▼ 559050 Hand In Heart Home Health Inc 5450 Ralston Street, Unit 202 Ventura CA 9 (San Francisco) 01/12/2023 5DD7C-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0454 HHA can no longer meet the patient's needs Element
G0596 Revisions communicated to patient and MDs Element
▼ 559061 Bellestar Home Health Care, Inc 1568 Creekside Drive Suite #203 Folsom CA 9 (San Francisco) 01/14/2026 1E02B7-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
G0520 5 calendar days after start of care Element
G0590 Promptly alert relevant physician of changes Element
▼ 559061 Bellestar Home Health Care, Inc 1568 Creekside Drive Suite #203 Folsom CA 9 (San Francisco) 12/02/2022 5E698-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0710 Provide services in the plan of care Element
G0716 Preparing clinical notes Element
▼ 559076 Eagle Home Health 6005 Vineland Ave, Suite 204 N Hollywood CA 9 (San Francisco) 05/31/2024 6339A-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
G0412 Written notice of patient's rights Element
G0532 Continuing need for home care Element
G0536 A review of all current medications Element
G0590 Promptly alert relevant physician of changes Element
G0610 Patients receive education and training Element
▼ 559089 G&A Home Health Care Inc 14545 Friar St, Suite 230 Van Nuys CA 9 (San Francisco) 01/22/2021 7BBY11 Complaint, Sample Validation
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0374 Accuracy of encoded OASIS data Standard
G0572 Plan of care Standard
G0682 Infection Prevention Standard
G0798 Home health aide assignments and duties Standard
G0484 Document complaint and resolution Element
G0536 A review of all current medications Element
G0588 Reviewed, revised by physician every 60 days Element
G0602 Communication with all physicians Element
G0610 Patients receive education and training Element
G0808 Onsite supervisory visit every 14 days Element
G0952 Ensure that HHA employs qualified personnel Element