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
▼ 059525 Tender Home Health 17031 Chatsworth Street #201 Granada Hills CA 9 (San Francisco) 05/19/2022 4EB90-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G1010 Contents of clinical record Standard
▼ 059525 Tender Home Health 17031 Chatsworth Street #201 Granada Hills CA 9 (San Francisco) 02/15/2022 38416-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0406 Patient rights Condition
G0510 Comprehensive Assessment of Patients Condition
G0570 Care planning, coordination, quality of care Condition
G0640 Quality assessment/performance improvement Condition
G0848 Compliance with Federal, State, Local Law Condition
G1008 Clinical records Condition
G0374 Accuracy of encoded OASIS data Standard
G0452 Transfer and discharge Standard
G0564 Discharge or Transfer Summary Content Standard
G0572 Plan of care Standard
G0612 Written instructions to patient include: Standard
G0642 Program scope Standard
G0644 Program data Standard
G0660 Executive responsibilities for QAPI Standard
G1024 Authentication Standard
G0410 Information to patient Element
G0412 Written notice of patient's rights Element
G0414 HHA administrator contact information Element
G0418 Patient's or legal representative's signature Element
G0436 Receive all services in plan of care Element
G0514 RN performs assessment Element
G0532 Continuing need for home care Element
G0534 Patient's needs Element
G0536 A review of all current medications Element
G0538 Primary caregiver(s), if any Element
G0546 Last 5 days of every 60 days unless: Element
G0550 At discharge Element
G0574 Plan of care must include the following Element
G0580 Only as ordered by a physician Element
G0602 Communication with all physicians Element
G0606 Integrate all services Element
G0608 Coordinate care delivery Element
G0648 High risk, high volume, or problem-prone area Element
G0650 Incidence, prevalence, severity of problems Element
G0656 Improvements are sustained Element
G0808 Onsite supervisory visit every 14 days Element
G1020 Contact info for primary care practitioner Element
G1022 Discharge and transfer summaries Element
▼ 059531 Laguna Home Health Services, Llc 25909 Pala, Suite 320 Mission Viejo CA 9 (San Francisco) 07/06/2026 25C6BE-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0606 Integrate all services Element
▼ 059557 Soteria Home Health Agency, Inc. 959 N. La Brea Avenue Inglewood CA 9 (San Francisco) 06/01/2023 5FEB6-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0572 Plan of care Standard
G0612 Written instructions to patient include: Standard
G0682 Infection Prevention Standard
G0580 Only as ordered by a physician Element
G0710 Provide services in the plan of care Element
▼ 059557 Soteria Home Health Agency, Inc. 959 N. La Brea Avenue Inglewood CA 9 (San Francisco) 11/03/2019 R1OB11 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0590 Promptly alert relevant physician of changes Element
G0710 Provide services in the plan of care Element
▼ 059566 Supreme Home Health Agency Inc 7177 Brockton Ave., Suite 451 Riverside CA 9 (San Francisco) 02/29/2024 6252B-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0372 Encoding and transmitting OASIS Standard
G0768 Competency evaluation Standard
G0536 A review of all current medications Element
G0584 Verbal orders Element
G0772 Documentation of competency evaluation Element
G0952 Ensure that HHA employs qualified personnel Element
▼ 059569 Founding Fathers Health Care, Inc. 1307 W 6th St Suite 201 Corona CA 9 (San Francisco) 09/19/2018 VESW11 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G1028 Protection of records Standard
G0536 A review of all current medications Element
▼ 059575 Valley Regional Home Health, Inc 6311 N Fresno St, Suite 102 Fresno CA 9 (San Francisco) 02/24/2021 ZF9911 Complaint, Sample Validation
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
G0590 Promptly alert relevant physician of changes Element
G0710 Provide services in the plan of care Element
▼ 059579 Healthy Living At Home - Redding Llc 1636 East Street Redding CA 9 (San Francisco) 05/21/2026 231FB3-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0572 Plan of care Standard
G0710 Provide services in the plan of care Element
▼ 059581 Miji Care Of Fresno, Inc. 3433 W Shaw Ave Suite 105 Fresno CA 9 (San Francisco) 08/22/2019 89KH11 Complaint, Sample Validation
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0942 Governing body Standard
G0606 Integrate all services Element
G0952 Ensure that HHA employs qualified personnel Element