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
▼ 059597 United Nursing Personal Care, Inc. 14070 Hesperia Road Victorville CA 9 (San Francisco) 06/28/2024 638B0-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
G0680 Infection prevention and control Condition
G0940 Organization and administration of services Condition
E0031 Emergency Officials Contact Information Standard
G0642 Program scope Standard
G0644 Program data Standard
G0682 Infection Prevention Standard
G0684 Infection control Standard
G0774 12 hours inservice every 12 months Standard
G0860 Licensing Standard
G0942 Governing body Standard
G0536 A review of all current medications Element
G0952 Ensure that HHA employs qualified personnel Element
▼ 059600 Caremetrix Home Health, Llc 22024 Lassen Street, Suite 100 Chatsworth CA 9 (San Francisco) 09/09/2019 WLYI11 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0572 Plan of care Standard
G0862 Laboratory services/CLIA waivers Standard
G0536 A review of all current medications Element
G0574 Plan of care must include the following Element
G0948 Responsible for all day-to-day operations Element
▼ 059604 J And S Home Health Services, Inc 2525 E Colorado Blvd, Ste 108 Pasadena CA 9 (San Francisco) 04/19/2018 5TUC11 Complaint, Sample Validation
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0572 Plan of care Standard
G0590 Promptly alert relevant physician of changes Element
G0604 Integrate all orders Element
G0710 Provide services in the plan of care Element
▼ 059612 Prohealth Home Health Care, Inc 1776 West March Lane, Suite 400a Stockton CA 9 (San Francisco) 05/04/2023 5FA42-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0374 Accuracy of encoded OASIS data Standard
G0572 Plan of care Standard
G0578 Conformance with physician orders Standard
G0536 A review of all current medications Element
G0550 At discharge Element
G0608 Coordinate care delivery Element
G0710 Provide services in the plan of care Element
G0726 Nursing services supervised by RN Element
G0808 Onsite supervisory visit every 14 days Element
▼ 059612 Prohealth Home Health Care, Inc 1776 West March Lane, Suite 400a Stockton CA 9 (San Francisco) 04/11/2018 H7L411 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0143 COORDINATION OF PATIENT SERVICES Standard
G0157 ACCEPTANCE OF PATIENTS, POC, MED SUPER Standard
G0165 CONFORMANCE WITH PHYSICIAN ORDERS Standard
G0236 CLINICAL RECORDS Standard
▼ 059623 P.A.L. Loving Care Home Health, Inc. 2829 N San Fernando Rd Suite 211 Los Angeles CA 9 (San Francisco) 09/18/2022 4F6C6-H1 Recertification
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
G0686 Infection control education Standard
G0536 A review of all current medications Element
G0602 Communication with all physicians Element
G0610 Patients receive education and training Element
▼ 059624 A&C Healthcare, Inc 20465 East Valley Blvd Walnut CA 9 (San Francisco) 08/19/2022 4F3E5-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
G0682 Infection Prevention Standard
G0602 Communication with all physicians Element
▼ 059624 A&C Healthcare, Inc 20465 East Valley Blvd Walnut CA 9 (San Francisco) 09/23/2019 B04011 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
▼ 059634 Rehab Home Health, Inc. 2250 Douglas Blvd Roseville CA 9 (San Francisco) 01/15/2019 TB2Y11 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G1008 Clinical records Condition
▼ 059641 Camarillo Hhca Inc 18107 Sherman Way, Suite 212 Reseda CA 9 (San Francisco) 02/13/2018 91EE11 Recertification, Sample Validation
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0410 Information to patient Element
G0436 Receive all services in plan of care Element
G0580 Only as ordered by a physician Element
G0616 Patient medication schedule/instructions Element
G1016 Goals in the patient's plans of care Element