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
▼ 058126 Carechoices Home Health Services, Llc 1501 E Orangethorpe Avenue, Suite 220 Fullerton CA 9 (San Francisco) 03/26/2025 65A6B-H1 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
E0021 HHA- Procedures for Follow up Staff/Pts. Standard
E0031 Emergency Officials Contact Information Standard
E0032 Primary/Alternate Means for Communication Standard
E0037 EP Training Program Standard
E0039 EP Testing Requirements Standard
G0372 Encoding and transmitting OASIS Standard
G0572 Plan of care Standard
G0642 Program scope Standard
G0658 Performance improvement projects Standard
G0682 Infection Prevention Standard
G0684 Infection control Standard
G0686 Infection control education Standard
G0798 Home health aide assignments and duties Standard
G1024 Authentication Standard
G0422 Written notice within 4 business days 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
G0576 All orders recorded in plan of care Element
G0580 Only as ordered by a physician Element
G0588 Reviewed, revised by physician every 60 days Element
G0590 Promptly alert relevant physician of changes Element
G0606 Integrate all services Element
G0614 Visit schedule 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
G0800 Services provided by HH aide Element
G0808 Onsite supervisory visit every 14 days Element
G0984 In accordance with current clinical practice Element
G1014 Interventions and patient response Element
G1022 Discharge and transfer summaries Element
▼ 058126 Carechoices Home Health Services, Llc 1501 E Orangethorpe Avenue, Suite 220 Fullerton CA 9 (San Francisco) 05/18/2022 38A57-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
E0006 Plan Based on All Hazards Risk Assessment Standard
E0021 HHA- Procedures for Follow up Staff/Pts. Standard
E0024 Policies/Procedures-Volunteers and Staffing Standard
E0030 Names and Contact Information Standard
E0039 EP Testing Requirements Standard
G0586 Review and revision of the plan of care Standard
G0642 Program scope Standard
G0684 Infection control Standard
G0774 12 hours inservice every 12 months Standard
G0798 Home health aide assignments and duties 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
G0538 Primary caregiver(s), if any Element
G0574 Plan of care must include the following Element
G0584 Verbal orders Element
G0602 Communication with all physicians Element
G0608 Coordinate care delivery Element
G0614 Visit schedule Element
G0710 Provide services in the plan of care Element
G0716 Preparing clinical notes Element
G0800 Services provided by HH aide Element
G0804 Aides are members of interdisciplinary team Element
G0808 Onsite supervisory visit every 14 days Element
G0948 Responsible for all day-to-day operations Element
G0984 In accordance with current clinical practice Element
G1022 Discharge and transfer summaries Element
▼ 058126 Carechoices Home Health Services, Llc 1501 E Orangethorpe Avenue, Suite 220 Fullerton CA 9 (San Francisco) 08/01/2018 Y06211 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
E0023 Policies/Procedures for Medical Documentation Standard
E0024 Policies/Procedures-Volunteers and Staffing Standard
E0033 Methods for Sharing Information Standard
E0034 Information on Occupancy/Needs Standard
E0037 EP Training Program Standard
G0658 Performance improvement projects Standard
G0684 Infection control Standard
G1024 Authentication Standard
G0444 State toll free HH telephone hotline 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
G0580 Only as ordered by a physician Element
G0584 Verbal orders Element
G0608 Coordinate care delivery Element
G0610 Patients receive education and training Element
G0614 Visit schedule Element
G0710 Provide services in the plan of care Element
G0716 Preparing clinical notes Element
G0726 Nursing services supervised by RN Element
G0800 Services provided by HH aide Element
G0808 Onsite supervisory visit every 14 days Element
G0948 Responsible for all day-to-day operations Element
G0984 In accordance with current clinical practice Element
G1022 Discharge and transfer summaries Element
▼ 058127 Fountain Home Health Inc 8349 Foothill Blvd Suite B Sunland CA 9 (San Francisco) 08/13/2022 4F370-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0570 Care planning, coordination, quality of care Condition
G0572 Plan of care Standard
G0444 State toll free HH telephone hotline Element
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
G0592 Revised plan of care Element
▼ 058127 Fountain Home Health Inc 8349 Foothill Blvd Suite B Sunland CA 9 (San Francisco) 05/02/2019 944B11 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
G0710 Provide services in the plan of care Element
▼ 058128 Pristine Home Health Inc 1419 N San Fernando Blvd, Suite 100 Burbank CA 9 (San Francisco) 10/27/2022 5DD49-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0952 Ensure that HHA employs qualified personnel Element
▼ 058129 Pasadena Home Health Care 183 E Glenarm St Unit 103 Pasadena CA 9 (San Francisco) 05/01/2022 38A06-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G1024 Authentication Standard
G0536 A review of all current medications Element
▼ 058129 Pasadena Home Health Care 183 E Glenarm St Unit 103 Pasadena CA 9 (San Francisco) 02/19/2019 MQ6K11 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0572 Plan of care Standard
▼ 058131 Mission Home Health Services, Inc 505 S Virgil Ave Suite 305 Los Angeles CA 9 (San Francisco) 11/23/2022 5E573-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
▼ 058131 Mission Home Health Services, Inc 505 S Virgil Ave Suite 305 Los Angeles CA 9 (San Francisco) 08/11/2019 T20D11 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