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
▼ 057753 Better Health Home Care, Inc 1535 W Merced Ave Suite 204 West Covina CA 9 (San Francisco) 06/12/2022 4ED41-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
G1028 Protection of records Standard
G0536 A review of all current medications Element
G0580 Only as ordered by a physician Element
G0590 Promptly alert relevant physician of changes Element
G0710 Provide services in the plan of care Element
▼ 057753 Better Health Home Care, Inc 1535 W Merced Ave Suite 204 West Covina CA 9 (San Francisco) 10/21/2019 Z3J011 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
G0714 Patient and caregiver education Element
▼ 057772 City & County Of San Francisco 375 Laguna Honda Blvd, Unit F5 San Francisco CA 9 (San Francisco) 07/19/2023 608B5-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0512 Standard: Initial assessment visit. Standard
G0572 Plan of care Standard
G0682 Infection Prevention Standard
G1012 Required items in clinical record Element
▼ 057786 Antelope Valley Home Care 44335 Lowtree Avenue Lancaster CA 9 (San Francisco) 02/20/2026 1E44D8-H1 Complaint
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
G1024 Authentication Standard
G0536 A review of all current medications Element
G0574 Plan of care must include the following Element
G0576 All orders recorded in plan of care Element
G0588 Reviewed, revised by physician every 60 days Element
G0590 Promptly alert relevant physician of changes Element
G1022 Discharge and transfer summaries Element
▼ 057788 Torrance Memorial Medical Center 3121 Skypark Dr. Suite 3124 Torrance CA 9 (San Francisco) 12/20/2024 64EEB-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0510 Comprehensive Assessment of Patients Condition
G0570 Care planning, coordination, quality of care Condition
G0536 A review of all current medications Element
G0574 Plan of care must include the following Element
▼ 057795 Kaiser Foundation Hospitals 21263 Erwin Street Woodland Hills CA 9 (San Francisco) 06/18/2025 666E2-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0510 Comprehensive Assessment of Patients Condition
G0570 Care planning, coordination, quality of care Condition
G1008 Clinical records Condition
G0572 Plan of care Standard
G0436 Receive all services in plan of care Element
G0520 5 calendar days after start of care Element
G0528 Health, psychosocial, functional, cognition Element
G0536 A review of all current medications Element
G0574 Plan of care must include the following Element
G0576 All orders recorded in plan of care Element
G0580 Only as ordered by a physician Element
G0590 Promptly alert relevant physician of changes Element
G0606 Integrate all services Element
G0610 Patients receive education and training Element
G0614 Visit schedule Element
G0616 Patient medication schedule/instructions Element
G0726 Nursing services supervised by RN Element
G1012 Required items in clinical record Element
G1014 Interventions and patient response Element
▼ 057799 Kaiser Foundation Hospitals 17542 E 17th Street Tustin CA 9 (San Francisco) 11/05/2025 1DA699-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
G0546 Last 5 days of every 60 days unless: Element
G0574 Plan of care must include the following Element
▼ 057799 Kaiser Foundation Hospitals 17542 E 17th Street Tustin CA 9 (San Francisco) 07/09/2025 66986-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0572 Plan of care Standard
G0574 Plan of care must include the following Element
G0580 Only as ordered by a physician Element
G0604 Integrate all orders Element
G0606 Integrate all services Element
▼ 057799 Kaiser Foundation Hospitals 17542 E 17th Street Tustin CA 9 (San Francisco) 12/17/2024 64E2F-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0574 Plan of care must include the following Element
G0608 Coordinate care delivery Element
▼ 058000 Excellent In-Home Care, Inc. 22041 Clarendon Street Suite 100 Woodland Hills CA 9 (San Francisco) 08/12/2022 4F2F2-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0536 A review of all current medications Element
G0574 Plan of care must include the following Element
G1018 Contact information for the patient Element
G1022 Discharge and transfer summaries Element