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
▼ 058083 Aloha Healthcare 4845 Cheyenne Way Chino CA 9 (San Francisco) 01/31/2019 UWRO11 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0544 Update of the comprehensive assessment Standard
G0572 Plan of care Standard
▼ 058084 Healing Hands Home Health Care 2525 Colorado Blvd Suite D Los Angeles CA 9 (San Francisco) 03/26/2023 5F5FB-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
G0684 Infection control Standard
G0536 A review of all current medications Element
G0580 Only as ordered by a physician Element
G0592 Revised plan of care Element
G0610 Patients receive education and training Element
▼ 058085 Horizon Home Care, Inc 12440 Firestone Blvd, Suite 205 Norwalk CA 9 (San Francisco) 08/21/2022 4F415-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
E0004 Develop EP Plan, Review and Update Annually Standard
G1010 Contents of clinical record Standard
G0514 RN performs assessment Element
G0536 A review of all current medications Element
G0604 Integrate all orders Element
G0608 Coordinate care delivery Element
G0772 Documentation of competency evaluation Element
▼ 058085 Horizon Home Care, Inc 12440 Firestone Blvd, Suite 205 Norwalk CA 9 (San Francisco) 02/28/2019 O7ZG11 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0536 A review of all current medications Element
▼ 058089 S&F Home Health Opco I, Llc 700 N. Central Ave. Suite 260 Glendale CA 9 (San Francisco) 07/20/2022 4F0A4-H1 Recertification
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
G0526 Content of the comprehensive assessment Standard
G0536 A review of all current medications Element
G0580 Only as ordered by a physician Element
G0610 Patients receive education and training Element
▼ 058089 S&F Home Health Opco I, Llc 700 N. Central Ave. Suite 260 Glendale CA 9 (San Francisco) 08/11/2019 44KB11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0682 Infection Prevention Standard
G0684 Infection control 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
▼ 058094 Sta Rita Health Systems, Inc 12241 Firestone Blvd, Suite C & D Norwalk CA 9 (San Francisco) 08/11/2022 4F30F-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0572 Plan of care Standard
G0536 A review of all current medications Element
G0574 Plan of care must include the following Element
G0590 Promptly alert relevant physician of changes Element
▼ 058097 Western States Homehealth Care Agency, Inc 5777 W Century Blvd Suite 610 Los Angeles CA 9 (San Francisco) 12/08/2022 5E74F-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
G0514 RN performs assessment Element
G0536 A review of all current medications Element
G0574 Plan of care must include the following Element
G0610 Patients receive education and training Element
▼ 058097 Western States Homehealth Care Agency, Inc 5777 W Century Blvd Suite 610 Los Angeles CA 9 (San Francisco) 03/27/2019 SKA111 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
G0574 Plan of care must include the following Element
G0580 Only as ordered by a physician Element
G0714 Patient and caregiver education Element
▼ 058099 Sunshine Home Health Ii, Inc. 3037 Hopyard Rd Pleasanton CA 9 (San Francisco) 02/07/2019 07KF11 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0376 Transmittal of OASIS data Standard
G0682 Infection Prevention Standard
G0536 A review of all current medications Element
G0574 Plan of care must include the following Element
G0602 Communication with all physicians Element
G0608 Coordinate care delivery Element
G0708 Development and evaluation of plan of care Element