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
▼ 057212 Port City Operating Company, Llc 3555 Deer Park Drive Stockton CA 9 (San Francisco) 06/22/2018 7YSK11 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
G0616 Patient medication schedule/instructions Element
G1014 Interventions and patient response Element
▼ 057214 Inhome Healthcare Services 5105 E Dakota Ave Suite 101 Fresno CA 9 (San Francisco) 08/30/2018 LXDI11 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0774 12 hours inservice every 12 months Standard
G0520 5 calendar days after start of care Element
G0584 Verbal orders Element
G0608 Coordinate care delivery Element
G0804 Aides are members of interdisciplinary team Element
G0808 Onsite supervisory visit every 14 days Element
▼ 057234 John C Fremont H C Dist Hha 5108 Highway 140, Ste C Mariposa CA 9 (San Francisco) 09/25/2023 5F0D1-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0862 Laboratory services/CLIA waivers Standard
G0536 A review of all current medications Element
▼ 057246 Anchor Healthcare, Llc 280 Atlantic Ave Long Beach CA 9 (San Francisco) 07/15/2022 4F034-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
G0536 A review of all current medications Element
G0580 Only as ordered by a physician Element
G0710 Provide services in the plan of care Element
G0984 In accordance with current clinical practice Element
G1022 Discharge and transfer summaries Element
▼ 057252 Joshua Tree Healthcare, Inc. 75410 Gerald Ford Drive Palm Desert CA 9 (San Francisco) 07/25/2025 66024-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G1076 Social Worker Standard
G0536 A review of all current medications Element
G0584 Verbal orders Element
G0984 In accordance with current clinical practice Element
▼ 057252 Joshua Tree Healthcare, Inc. 75410 Gerald Ford Drive Palm Desert CA 9 (San Francisco) 03/23/2022 38771-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
G0536 A review of all current medications Element
G0590 Promptly alert relevant physician of changes Element
▼ 057252 Joshua Tree Healthcare, Inc. 75410 Gerald Ford Drive Palm Desert CA 9 (San Francisco) 02/20/2018 O89V11 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0572 Plan of care Standard
G0412 Written notice of patient's rights Element
G0536 A review of all current medications Element
G0550 At discharge Element
G0580 Only as ordered by a physician Element
G0714 Patient and caregiver education Element
G0952 Ensure that HHA employs qualified personnel Element
▼ 057256 Cp Humboldt N - Ca Hh, Llc 2127 Harrison Ave Eureka CA 9 (San Francisco) 09/22/2023 610B0-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
E0042 Integrated EP Program Standard
G0718 Communication with physicians Element
▼ 057258 Rcr Star Management Of San Jose, Inc 950 S Bascom Avenue, Suite 2007 San Jose CA 9 (San Francisco) 12/06/2019 NOVN11 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
E0009 Local, State, Tribal Collaboration Process Standard
E0017 HHA Comprehensive Assessment in Disaster Standard
G0862 Laboratory services/CLIA waivers Standard
G0982 Skilled services furnished Standard
G0514 RN performs assessment Element
G0948 Responsible for all day-to-day operations Element
G1022 Discharge and transfer summaries Element
▼ 057276 John Muir Home Health Care 2298 Pike Court Concord CA 9 (San Francisco) 11/14/2024 6492E-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0528 Health, psychosocial, functional, cognition Element
G0574 Plan of care must include the following Element