S&C QCOR HHA 2567s
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HHAs 2567s
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Time Interval

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Provider Characteristics

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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
▼ 057564 Accentcare Home Health Of California, Inc 5050 Murphy Canyon Road, Suite 202 San Diego CA 9 (San Francisco) 02/28/2018 EM1811 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0590 Promptly alert relevant physician of changes Element
G0592 Revised plan of care Element
G0608 Coordinate care delivery Element
G0800 Services provided by HH aide Element
▼ 057567 Pec Healthcare 10507 Garden Grove Blvd Garden Grove CA 9 (San Francisco) 03/29/2023 5F524-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0642 Program scope Standard
G0682 Infection Prevention Standard
G0684 Infection control Standard
G1024 Authentication Standard
G0478 Investigate complaints made by patient Element
G0536 A review of all current medications Element
G0548 Within 48 hours of the patient's return Element
G0574 Plan of care must include the following Element
G0584 Verbal orders Element
G0606 Integrate all services Element
G0608 Coordinate care delivery Element
G0614 Visit schedule Element
G0622 Name/contact information of clinical manager Element
G0710 Provide services in the plan of care Element
G0716 Preparing clinical notes Element
G1022 Discharge and transfer summaries Element
▼ 057567 Pec Healthcare 10507 Garden Grove Blvd Garden Grove CA 9 (San Francisco) 01/25/2018 ISP511 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
E0017 HHA Comprehensive Assessment in Disaster Standard
E0023 Policies/Procedures for Medical Documentation Standard
E0024 Policies/Procedures-Volunteers and Staffing Standard
G0372 Encoding and transmitting OASIS Standard
G0798 Home health aide assignments and duties Standard
G0806 Supervision of home health aides Standard
G1024 Authentication Standard
G0478 Investigate complaints made by patient Element
G0514 RN performs assessment Element
G0520 5 calendar days after start of care Element
G0536 A review of all current medications Element
G0546 Last 5 days of every 60 days unless: Element
G0550 At discharge Element
G0574 Plan of care must include the following Element
G0584 Verbal orders Element
G0606 Integrate all services Element
G0608 Coordinate care delivery Element
G0610 Patients receive education and training Element
G0710 Provide services in the plan of care Element
G0714 Patient and caregiver education Element
G0716 Preparing clinical notes Element
G0800 Services provided by HH aide Element
G0948 Responsible for all day-to-day operations Element
▼ 057569 Ac Health, Inc. 1843 E Fir Avenue, Ste 101 Fresno CA 9 (San Francisco) 09/29/2022 4F722-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0682 Infection Prevention Standard
G0574 Plan of care must include the following Element
▼ 057570 Self-Help For The Elderly 731 Sansome Street, Suite 100 San Francisco CA 9 (San Francisco) 07/11/2024 63895-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0682 Infection Prevention Standard
G0444 State toll free HH telephone hotline Element
G0536 A review of all current medications Element
G0588 Reviewed, revised by physician every 60 days Element
G0592 Revised plan of care Element
G0710 Provide services in the plan of care Element
G0716 Preparing clinical notes Element
G0718 Communication with physicians Element
▼ 057571 Covenant Care At Home 125 North Broadway Suite 1b Turlock CA 9 (San Francisco) 03/26/2026 1F51F2-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
G0682 Infection Prevention Standard
G0536 A review of all current medications Element
G0808 Onsite supervisory visit every 14 days Element
▼ 057571 Covenant Care At Home 125 North Broadway Suite 1b Turlock CA 9 (San Francisco) 03/21/2023 5F2FD-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0514 RN performs assessment Element
G0580 Only as ordered by a physician Element
G0608 Coordinate care delivery Element
▼ 057573 Accentcare Home Health Of California, Inc. 3636 Birch Street, Suite 195 Newport Beach CA 9 (San Francisco) 02/13/2018 FSTJ11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
E0009 Local, State, Tribal Collaboration Process Standard
E0013 Development of EP Policies and Procedures Standard
E0017 HHA Comprehensive Assessment in Disaster Standard
E0024 Policies/Procedures-Volunteers and Staffing Standard
E0029 Development of Communication Plan Standard
E0032 Primary/Alternate Means for Communication Standard
E0034 Information on Occupancy/Needs Standard
E0037 EP Training Program Standard
G0372 Encoding and transmitting OASIS Standard
G0572 Plan of care Standard
G0478 Investigate complaints made by patient Element
G0520 5 calendar days after start of care Element
G0536 A review of all current medications Element
G0546 Last 5 days of every 60 days unless: Element
G0548 Within 48 hours of the patient's return Element
G0574 Plan of care must include the following Element
G0580 Only as ordered by a physician Element
G0592 Revised plan of care Element
G0606 Integrate all services Element
G0710 Provide services in the plan of care Element
G0714 Patient and caregiver education Element
G0716 Preparing clinical notes Element
G0726 Nursing services supervised by RN Element
G0728 Rehab services supervised by PT, OT Element
G0948 Responsible for all day-to-day operations Element
▼ 057600 Cp Orange County S-Ca Hh, Llc 200 W Center Street Promenade Anaheim CA 9 (San Francisco) 04/17/2026 22E6C2-H1 Complaint
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
G0580 Only as ordered by a physician Element
G0602 Communication with all physicians Element
▼ 057600 Cp Orange County S-Ca Hh, Llc 200 W Center Street Promenade Anaheim CA 9 (San Francisco) 03/19/2026 1F50B6-H1 Complaint
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
G0580 Only as ordered by a physician Element
G0948 Responsible for all day-to-day operations Element