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
▼ 058156 Assisted Healthcare Services 1126 N Grand Ave Suite 201 Covina CA 9 (San Francisco) 12/30/2019 6U0S11 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0572 Plan of care Standard
▼ 058160 Caring Hands Home Health Agency, Inc. 5701 Slauson Ave, Suite 202 Culver City CA 9 (San Francisco) 12/30/2022 5E9A4-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
E0037 EP Training Program Standard
G0612 Written instructions to patient include: Standard
G0588 Reviewed, revised by physician every 60 days Element
G0620 Other pertinent instructions Element
▼ 058160 Caring Hands Home Health Agency, Inc. 5701 Slauson Ave, Suite 202 Culver City CA 9 (San Francisco) 07/29/2019 UCDJ11 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0434 Participate in care Element
G0522 Eligibility for Medicare home health benefit Element
G0580 Only as ordered by a physician Element
G0718 Communication with physicians Element
▼ 058161 Los Angeles Home Health Care Agency, Inc. 2741 S Robertson Blvd 2nd Floor Los Angeles CA 9 (San Francisco) 11/11/2022 5E3CC-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
E0036 EP Training and Testing Standard
G0684 Infection control Standard
G0530 Strengths, goals, and care preferences Element
G0536 A review of all current medications Element
▼ 058163 Hye Nurses Home Health Inc 12011 Victory Blvd, Suite 202 N Hollywood CA 9 (San Francisco) 07/10/2022 4EFC4-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
G0808 Onsite supervisory visit every 14 days Element
▼ 058163 Hye Nurses Home Health Inc 12011 Victory Blvd, Suite 202 N Hollywood CA 9 (San Francisco) 02/13/2019 RET011 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
E0036 EP Training and Testing Standard
G0572 Plan of care Standard
G1058 Home Health Aide Standard
G0590 Promptly alert relevant physician of changes Element
▼ 058164 Vision Home Health Care, Inc 5750 Division Street, Suite 206 Riverside CA 9 (San Francisco) 12/13/2019 ATGE11 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0436 Receive all services in plan of care Element
G0536 A review of all current medications Element
G0582 Influenza and pneumococcal vaccines Element
G0610 Patients receive education and training Element
G0984 In accordance with current clinical practice Element
▼ 058165 Unison Health Services, Inc 2200 S Fremont Ave Unit 202 Alhambra CA 9 (San Francisco) 12/22/2023 61C7D-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0682 Infection Prevention Standard
G0412 Written notice of patient's rights Element
G0484 Document complaint and resolution Element
G0522 Eligibility for Medicare home health benefit Element
G0536 A review of all current medications Element
G0608 Coordinate care delivery Element
▼ 058165 Unison Health Services, Inc 2200 S Fremont Ave Unit 202 Alhambra CA 9 (San Francisco) 08/18/2023 60C16-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
G0682 Infection Prevention Standard
G0410 Information to patient Element
G0412 Written notice of patient's rights Element
G0536 A review of all current medications Element
G0710 Provide services in the plan of care Element
G0714 Patient and caregiver education Element
G0718 Communication with physicians Element
▼ 058167 Health Care Solutions Services, Inc 265 S Randolph Ave, Suite 280 Brea CA 9 (San Francisco) 08/08/2023 609C1-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
E0006 Plan Based on All Hazards Risk Assessment Standard
E0007 EP Program Patient Population Standard
E0009 Local, State, Tribal Collaboration Process Standard
E0013 Development of EP Policies and Procedures Standard
E0019 Homebound HHA/Hospice Inform EP Officials Standard
E0021 HHA- Procedures for Follow up Staff/Pts. Standard
E0023 Policies/Procedures for Medical Documentation Standard
E0024 Policies/Procedures-Volunteers and Staffing Standard
E0029 Development of Communication Plan Standard
E0030 Names and Contact Information Standard
E0031 Emergency Officials Contact Information Standard
E0033 Methods for Sharing Information Standard
E0036 EP Training and Testing Standard
E0037 EP Training Program Standard
G0586 Review and revision of the plan of care Standard
G0684 Infection control Standard
G0774 12 hours inservice every 12 months Standard
G0798 Home health aide assignments and duties Standard
G0942 Governing body Standard
G0478 Investigate complaints made by patient Element
G0484 Document complaint and resolution 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
G0608 Coordinate care delivery Element
G0610 Patients receive education and training Element
G0614 Visit schedule Element
G0618 Treatments and therapy services Element
G0710 Provide services in the plan of care Element
G0716 Preparing clinical notes Element
G0948 Responsible for all day-to-day operations Element
G1022 Discharge and transfer summaries Element