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
▼ 058053 Dsp Home Health Inc 1815 East Workman Ave Ste D West Covina CA 9 (San Francisco) 09/21/2018 3LVM11 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0710 Provide services in the plan of care Element
▼ 058054 Ars Health Care, Inc 12500 Riverside Dr, Suite 205 Valley Village CA 9 (San Francisco) 06/27/2022 3832B-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
G0660 Executive responsibilities for QAPI Standard
G0682 Infection Prevention Standard
G0686 Infection control education Standard
G0576 All orders recorded in plan of care Element
G0584 Verbal orders Element
G0954 Ensures qualified pre-designated person Element
▼ 058056 Home Health Services Of California, Inc 611 S Catalina St Suite 318 Los Angeles CA 9 (San Francisco) 03/10/2023 5F282-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0536 A review of all current medications Element
▼ 058056 Home Health Services Of California, Inc 611 S Catalina St Suite 318 Los Angeles CA 9 (San Francisco) 04/17/2019 7WJX11 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0572 Plan of care Standard
G0610 Patients receive education and training Element
▼ 058058 Accxell Home Health Agency 370 Amapola Avenue Suite 203 Torrance CA 9 (San Francisco) 09/18/2022 4EB2C-H3 Recertification
Deficiency Tag Deficiency Description Tag Type
G0600 Coordination of Care Standard
G0580 Only as ordered by a physician Element
G0608 Coordinate care delivery Element
▼ 058058 Accxell Home Health Agency 370 Amapola Avenue Suite 203 Torrance CA 9 (San Francisco) 05/23/2022 4EB2C-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0510 Comprehensive Assessment of Patients Condition
G0680 Infection prevention and control Condition
G0518 Completion of the comprehensive assessment Standard
G0682 Infection Prevention Standard
G0684 Infection control Standard
G1028 Protection of records Standard
G0532 Continuing need for home care Element
G0616 Patient medication schedule/instructions Element
▼ 058059 Los Robles Healthcare 509 Marin Street, Suite #135 Thousand Oaks CA 9 (San Francisco) 07/21/2022 4ECE2-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0452 Transfer and discharge Standard
G0710 Provide services in the plan of care Element
▼ 058063 Priority One Home Health Services Inc 4959 Palo Verde Street Suite 108c Montclair CA 9 (San Francisco) 05/21/2018 H3K911 Recertification, Sample Validation
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G1008 Clinical records Condition
G0682 Infection Prevention Standard
G1024 Authentication Standard
G1028 Protection of records Standard
G0580 Only as ordered by a physician Element
G0590 Promptly alert relevant physician of changes Element
G1012 Required items in clinical record Element
▼ 058065 The Center Of Home Health, Inc. 13017 Artesia Blvd Suite D210 Cerritos CA 9 (San Francisco) 01/29/2019 IVDS11 Recertification
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
G0610 Patients receive education and training Element
▼ 058067 Assisted Home Recovery, Inc. 3731 Wilshire Blvd Ste 516 Los Angeles CA 9 (San Francisco) 05/15/2022 4EAB5-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0528 Health, psychosocial, functional, cognition Element
G0536 A review of all current medications Element
G0576 All orders recorded in plan of care Element
G0608 Coordinate care delivery Element
G1012 Required items in clinical record Element