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
▼ 058233 Compassionate Care Home Health Agency 7545 N Del Mar Avenue, Suite 103 Fresno CA 9 (San Francisco) 04/15/2021 518511 Complaint, Sample Validation
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0570 Care planning, coordination, quality of care Condition
G0848 Compliance with Federal, State, Local Law Condition
G0682 Infection Prevention Standard
G0684 Infection control Standard
G0860 Licensing Standard
G0534 Patient's needs Element
G0536 A review of all current medications Element
G0580 Only as ordered by a physician Element
G0590 Promptly alert relevant physician of changes Element
▼ 058236 Xl Care, Inc 20350 Ventura Blvd Suite 140 Woodland Hills CA 9 (San Francisco) 06/12/2022 4ED5F-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0682 Infection Prevention Standard
G0536 A review of all current medications Element
▼ 058237 Aspen Healthcare Corporation 630 Roosevelt Suite A Irvine CA 9 (San Francisco) 10/09/2018 26QT11 Complaint, Sample Validation
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
G0702 Services by skilled professionals Standard
G0536 A review of all current medications Element
G0590 Promptly alert relevant physician of changes Element
G0610 Patients receive education and training Element
▼ 058238 Cp Orange County South S-Ca Hh Llc 38 Executive Park, Suite 390 Irvine CA 9 (San Francisco) 05/08/2026 230EC6-H1 Complaint
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
G0580 Only as ordered by a physician Element
G0602 Communication with all physicians Element
G0716 Preparing clinical notes Element
G0808 Onsite supervisory visit every 14 days Element
▼ 058238 Cp Orange County South S-Ca Hh Llc 38 Executive Park, Suite 390 Irvine CA 9 (San Francisco) 07/20/2023 6045A-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0586 Review and revision of the plan of care Standard
G0682 Infection Prevention Standard
G0684 Infection control Standard
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
G0548 Within 48 hours of the patient's return Element
G0550 At discharge Element
G0574 Plan of care must include the following Element
G0584 Verbal orders Element
G0608 Coordinate care delivery Element
G0614 Visit schedule Element
G0622 Name/contact information of clinical manager 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
▼ 058238 Cp Orange County South S-Ca Hh Llc 38 Executive Park, Suite 390 Irvine CA 9 (San Francisco) 07/23/2018 89FH12 Recertification
Deficiency Tag Deficiency Description Tag Type
G0374 Accuracy of encoded OASIS data Standard
▼ 058238 Cp Orange County South S-Ca Hh Llc 38 Executive Park, Suite 390 Irvine CA 9 (San Francisco) 06/12/2018 89FH11 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
E0037 EP Training Program Standard
G0372 Encoding and transmitting OASIS Standard
G0476 Investigation of complaints Standard
G0572 Plan of care Standard
G1024 Authentication Standard
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
G0710 Provide services in the plan of care Element
G0948 Responsible for all day-to-day operations Element
G0984 In accordance with current clinical practice Element
G1022 Discharge and transfer summaries Element
▼ 058239 Inland Home Health Providers, Inc 9221 Archibald Avenue Rancho Cucamonga CA 9 (San Francisco) 04/09/2026 22C42B-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
E0037 EP Training Program Standard
G0798 Home health aide assignments and duties Standard
G0942 Governing body Standard
G0428 Property and person treated with respect Element
G0536 A review of all current medications Element
G0580 Only as ordered by a physician Element
▼ 058239 Inland Home Health Providers, Inc 9221 Archibald Avenue Rancho Cucamonga CA 9 (San Francisco) 03/06/2020 OJ0B11 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
G0680 Infection prevention and control Condition
E0006 Plan Based on All Hazards Risk Assessment Standard
E0009 Local, State, Tribal Collaboration Process Standard
E0019 Homebound HHA/Hospice Inform EP Officials Standard
E0021 HHA- Procedures for Follow up Staff/Pts. Standard
E0024 Policies/Procedures-Volunteers and Staffing Standard
E0031 Emergency Officials Contact Information Standard
E0032 Primary/Alternate Means for Communication Standard
E0034 Information on Occupancy/Needs Standard
E0036 EP Training and Testing Standard
E0039 EP Testing Requirements Standard
G0684 Infection control Standard
G0536 A review of all current medications Element
G0580 Only as ordered by a physician Element
G0608 Coordinate care delivery Element
G0648 High risk, high volume, or problem-prone area Element
▼ 058242 Sierra Home Healthcare Services, Inc 2064 Marengo St # 400 Los Angeles CA 9 (San Francisco) 05/08/2022 38A65-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
G0572 Plan of care Standard
G0684 Infection control Standard
G0432 Make complaints to the HHA Element
G0580 Only as ordered by a physician Element
G0608 Coordinate care delivery Element