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
▼ 058281 Renaissance Home Health Care, Inc 3160 Camino Del Rio South Ste 312 San Diego CA 9 (San Francisco) 06/03/2021 WX2F11 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0602 Communication with all physicians Element
▼ 058281 Renaissance Home Health Care, Inc 3160 Camino Del Rio South Ste 312 San Diego CA 9 (San Francisco) 06/10/2019 UW0T11 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G1010 Contents of clinical record Standard
G0484 Document complaint and resolution Element
G0608 Coordinate care delivery Element
▼ 058281 Renaissance Home Health Care, Inc 3160 Camino Del Rio South Ste 312 San Diego CA 9 (San Francisco) 06/06/2019 UGVE11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
E0033 Methods for Sharing Information Standard
G0682 Infection Prevention Standard
G0436 Receive all services in plan of care Element
G0536 A review of all current medications Element
G0580 Only as ordered by a physician Element
G0584 Verbal orders Element
G0948 Responsible for all day-to-day operations Element
G1012 Required items in clinical record Element
▼ 058284 Infinity Health Services, Inc. 28441 Rancho California Rd, Ste 200 Temecula CA 9 (San Francisco) 07/21/2022 4F03B-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
G0710 Provide services in the plan of care Element
G0984 In accordance with current clinical practice Element
▼ 058287 Nightingale Home Care Inc 4579 Maple Avenue, Suite 2 & 4 La Mesa CA 9 (San Francisco) 12/17/2019 6TIU11 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0518 Completion of the comprehensive assessment Standard
▼ 058288 St Martin Home Healthcare 13771 Roswell Avenue, Suite H Chino CA 9 (San Francisco) 06/23/2023 6011B-H1 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
G0726 Nursing services supervised by RN Element
▼ 058289 Asap Home Health Service, Inc 602 Commerce Ave. Suite C Palmdale CA 9 (San Francisco) 01/26/2024 6207C-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
G0544 Update of the comprehensive assessment Standard
G0682 Infection Prevention Standard
G0768 Competency evaluation Standard
G0774 12 hours inservice every 12 months Standard
G1024 Authentication Standard
G1028 Protection of records Standard
G0444 State toll free HH telephone hotline Element
G0446 Contact info Federal/State-funded entities Element
G0536 A review of all current medications Element
G0546 Last 5 days of every 60 days unless: Element
G0710 Provide services in the plan of care Element
G0726 Nursing services supervised by RN Element
▼ 058289 Asap Home Health Service, Inc 602 Commerce Ave. Suite C Palmdale CA 9 (San Francisco) 08/25/2021 WY4X12 Recertification
Deficiency Tag Deficiency Description Tag Type
G0590 Promptly alert relevant physician of changes Element
▼ 058289 Asap Home Health Service, Inc 602 Commerce Ave. Suite C Palmdale CA 9 (San Francisco) 06/11/2021 WY4X11 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
G0510 Comprehensive Assessment of Patients Condition
G0570 Care planning, coordination, quality of care Condition
G0700 Skilled professional services Condition
G0750 Home health aide services Condition
G0848 Compliance with Federal, State, Local Law Condition
G1008 Clinical records Condition
E0004 Develop EP Plan, Review and Update Annually Standard
E0037 EP Training Program Standard
E0039 EP Testing Requirements Standard
G0526 Content of the comprehensive assessment Standard
G0544 Update of the comprehensive assessment Standard
G0572 Plan of care Standard
G0642 Program scope Standard
G0682 Infection Prevention Standard
G0798 Home health aide assignments and duties Standard
G0860 Licensing Standard
G0536 A review of all current medications Element
G0580 Only as ordered by a physician Element
G0592 Revised plan of care Element
G0608 Coordinate care delivery Element
G0610 Patients receive education and training Element
G0708 Development and evaluation of plan of care Element
G0710 Provide services in the plan of care Element
G0726 Nursing services supervised by RN Element
G0754 A qualified HH aide successfully completed: Element
G0808 Onsite supervisory visit every 14 days Element
G0954 Ensures qualified pre-designated person Element
G1012 Required items in clinical record Element
▼ 058289 Asap Home Health Service, Inc 602 Commerce Ave. Suite C Palmdale CA 9 (San Francisco) 05/16/2019 ID6O11 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0536 A review of all current medications Element