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
▼ 058167 Health Care Solutions Services, Inc 265 S Randolph Ave, Suite 280 Brea CA 9 (San Francisco) 01/10/2019 ESAM11 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
E0017 HHA Comprehensive Assessment in Disaster Standard
E0024 Policies/Procedures-Volunteers and Staffing Standard
E0031 Emergency Officials Contact Information Standard
G0518 Completion of the comprehensive assessment Standard
G0572 Plan of care Standard
G1024 Authentication Standard
G0484 Document complaint and resolution Element
G0536 A review of all current medications Element
G0546 Last 5 days of every 60 days unless: Element
G0574 Plan of care must include the following Element
G0584 Verbal orders Element
G0606 Integrate all services 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
G1022 Discharge and transfer summaries Element
▼ 058172 Mc Home Health Services, Inc 18800 Amar Road, Suite B-5 Walnut CA 9 (San Francisco) 04/14/2023 5F850-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0510 Comprehensive Assessment of Patients Condition
E0004 Develop EP Plan, Review and Update Annually Standard
G0572 Plan of care Standard
G1028 Protection of records Standard
G0532 Continuing need for home care Element
▼ 058172 Mc Home Health Services, Inc 18800 Amar Road, Suite B-5 Walnut CA 9 (San Francisco) 03/08/2020 KUV411 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0536 A review of all current medications Element
G0574 Plan of care must include the following Element
G0710 Provide services in the plan of care Element
▼ 058173 Mission Home Health Of East Bay, Llc 5976 W Las Positas Boulevard Suite 118 Pleasanton CA 9 (San Francisco) 11/09/2018 YTIC11 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0572 Plan of care Standard
G0578 Conformance with physician orders Standard
G0536 A review of all current medications Element
▼ 058180 Annex Healthcare Providers, Inc 22041 Clarendon Street Suite 200 Woodland Hills CA 9 (San Francisco) 01/03/2022 3818F-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0700 Skilled professional services Condition
G0682 Infection Prevention Standard
G0702 Services by skilled professionals Standard
G0536 A review of all current medications Element
G0580 Only as ordered by a physician Element
G0722 Participate in HHA-sponsored in-service Element
▼ 058181 Vanura Home Health Services, Inc 8213 Rochester Avenue Rancho Cucamonga CA 9 (San Francisco) 07/28/2023 60808-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0658 Performance improvement projects Standard
G0726 Nursing services supervised by RN Element
▼ 058181 Vanura Home Health Services, Inc 8213 Rochester Avenue Rancho Cucamonga CA 9 (San Francisco) 02/21/2020 N8ZH11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
E0001 Establishment of the Emergency Program (EP) Condition
E0006 Plan Based on All Hazards Risk Assessment Standard
E0007 EP Program Patient Population Standard
E0009 Local, State, Tribal Collaboration Process Standard
E0019 Homebound HHA/Hospice Inform EP Officials Standard
E0032 Primary/Alternate Means for Communication Standard
E0034 Information on Occupancy/Needs Standard
E0039 EP Testing Requirements Standard
G0578 Conformance with physician orders Standard
G1024 Authentication Standard
G0536 A review of all current medications Element
G0580 Only as ordered by a physician Element
G0726 Nursing services supervised by RN Element
G0808 Onsite supervisory visit every 14 days Element
▼ 058183 Excellent Care Home Health Services, Inc 13139 Central Ave. Chino CA 9 (San Francisco) 12/06/2019 GG5C11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0944 Administrator must: Standard
G1010 Contents of clinical record Standard
G0514 RN performs assessment Element
G0536 A review of all current medications Element
G0546 Last 5 days of every 60 days unless: Element
G0952 Ensure that HHA employs qualified personnel Element
G0954 Ensures qualified pre-designated person Element
▼ 058184 H.O.P.E. Professional Services, Inc. 11731 Sterling Avenue, Unit C Riverside CA 9 (San Francisco) 03/13/2025 658B1-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0372 Encoding and transmitting OASIS Standard
G0572 Plan of care Standard
G0528 Health, psychosocial, functional, cognition Element
G0536 A review of all current medications Element
G0576 All orders recorded in plan of care Element
▼ 058184 H.O.P.E. Professional Services, Inc. 11731 Sterling Avenue, Unit C Riverside CA 9 (San Francisco) 03/03/2022 3854D-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
G0574 Plan of care must include the following Element
G0592 Revised plan of care Element
G0614 Visit schedule Element