S&C QCOR HHA 2567s
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HHAs 2567s
Selection Criteria ▸

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
▼ 058039 Assisted Home Care 4450 Westinghouse Street, Suite #101 Ventura CA 9 (San Francisco) 04/09/2026 22C76B-H1 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
▼ 058039 Assisted Home Care 4450 Westinghouse Street, Suite #101 Ventura CA 9 (San Francisco) 08/31/2023 609E8-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0572 Plan of care Standard
▼ 058039 Assisted Home Care 4450 Westinghouse Street, Suite #101 Ventura CA 9 (San Francisco) 12/31/2019 3FQF11 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0536 A review of all current medications Element
G0590 Promptly alert relevant physician of changes Element
G0614 Visit schedule Element
▼ 058042 Capital Home Health Agency Inc 5751 W Adams Blvd Los Angeles CA 9 (San Francisco) 07/04/2022 4EF71-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
G0686 Infection control education Standard
G0536 A review of all current medications Element
G0580 Only as ordered by a physician Element
G0588 Reviewed, revised by physician every 60 days Element
▼ 058047 New Vision Home Health Agency, Inc 12145 Mora Drive, Unit 10 Santa Fe Springs CA 9 (San Francisco) 08/17/2022 4F3A0-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0687 COVID-19 Vaccination of Home Health Agency staff Standard
G1010 Contents of clinical record Standard
G0536 A review of all current medications Element
G0710 Provide services in the plan of care Element
G0714 Patient and caregiver education Element
▼ 058047 New Vision Home Health Agency, Inc 12145 Mora Drive, Unit 10 Santa Fe Springs CA 9 (San Francisco) 01/22/2019 IJ6511 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
G0580 Only as ordered by a physician Element
▼ 058049 Epic Homcare Inc. 6404 Wilshire Blvd #550 Los Angeles CA 9 (San Francisco) 01/04/2024 61DA6-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0536 A review of all current medications Element
G1022 Discharge and transfer summaries Element
▼ 058049 Epic Homcare Inc. 6404 Wilshire Blvd #550 Los Angeles CA 9 (San Francisco) 01/09/2022 38231-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0572 Plan of care Standard
G0682 Infection Prevention 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
G0714 Patient and caregiver education Element
▼ 058052 Dignity Health 2045 40th Avenue, Suite A Capitola CA 9 (San Francisco) 01/09/2020 QNKJ11 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0948 Responsible for all day-to-day operations Element
▼ 058053 Dsp Home Health Inc 1815 East Workman Ave Ste D West Covina CA 9 (San Francisco) 03/13/2022 38672-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0710 Provide services in the plan of care Element
G0984 In accordance with current clinical practice Element