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
▼ 057407 Kaiser Foundation Hospital Home Health - Santa Rosa 3550 Round Barn Blvd, Suite 112 Santa Rosa CA 9 (San Francisco) 07/24/2026 285264-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0572 Plan of care Standard
G0484 Document complaint and resolution Element
G0574 Plan of care must include the following Element
▼ 057407 Kaiser Foundation Hospital Home Health - Santa Rosa 3550 Round Barn Blvd, Suite 112 Santa Rosa CA 9 (San Francisco) 01/28/2019 WMMR11 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
E0017 HHA Comprehensive Assessment in Disaster Standard
G0484 Document complaint and resolution Element
G0536 A review of all current medications Element
G0718 Communication with physicians Element
▼ 057413 Managed Homecare Inc. 4740 Green River Road Suite 216 Corona CA 9 (San Francisco) 07/05/2024 637B3-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
G0612 Written instructions to patient include: Standard
G0536 A review of all current medications Element
G0584 Verbal orders Element
G0984 In accordance with current clinical practice Element
▼ 057413 Managed Homecare Inc. 4740 Green River Road Suite 216 Corona CA 9 (San Francisco) 12/13/2018 OT9P11 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0578 Conformance with physician orders Standard
G0682 Infection Prevention Standard
G0528 Health, psychosocial, functional, cognition Element
G0536 A review of all current medications Element
G1014 Interventions and patient response Element
▼ 057415 Uni Care Home Care, Inc. 1594 S Imperial Ave El Centro CA 9 (San Francisco) 03/27/2025 65AEB-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0372 Encoding and transmitting OASIS Standard
G0374 Accuracy of encoded OASIS data Standard
G0682 Infection Prevention Standard
G1012 Required items in clinical record Element
▼ 057415 Uni Care Home Care, Inc. 1594 S Imperial Ave El Centro CA 9 (San Francisco) 06/28/2018 QFS211 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
▼ 057426 Holistic Approach Inc. 5250 Claremont Avenue Stockton CA 9 (San Francisco) 02/25/2026 1E4839-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0372 Encoding and transmitting OASIS Standard
G0536 A review of all current medications Element
▼ 057427 Sutter Coast Home Care 785 E Washington Blvd, Suite 14 & 15 Crescent City CA 9 (San Francisco) 05/03/2018 B74211 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
E0017 HHA Comprehensive Assessment in Disaster Standard
G0484 Document complaint and resolution Element
G0620 Other pertinent instructions Element
G0710 Provide services in the plan of care Element
▼ 057445 Barry & Taffy, Inc 5955 Desoto Avenue Suite 160 Woodland Hills CA 9 (San Francisco) 03/29/2018 D2ZD11 Complaint, Sample Validation
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0466 Make efforts to resolve the problem(s) Element
G0602 Communication with all physicians Element
▼ 057447 Nurses On Wheels, Inc 16660 Paramount Blvd Ste 304 Paramount CA 9 (San Francisco) 05/17/2022 4EA85-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0570 Care planning, coordination, quality of care Condition
G0700 Skilled professional services Condition
G0572 Plan of care Standard
G0642 Program scope Standard
G0658 Performance improvement projects Standard
G0682 Infection Prevention Standard
G0942 Governing body 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
G0718 Communication with physicians Element
G0952 Ensure that HHA employs qualified personnel Element