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
▼ 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
▼ 058290 Excellence Home Health Care Agency Inc 11760 Central Avenue Suite 200 Chino CA 9 (San Francisco) 02/27/2025 656B1-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0372 Encoding and transmitting OASIS Standard
G0952 Ensure that HHA employs qualified personnel Element
G1012 Required items in clinical record Element
▼ 058290 Excellence Home Health Care Agency Inc 11760 Central Avenue Suite 200 Chino CA 9 (San Francisco) 02/17/2022 3836A-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
E0037 EP Training Program Standard
G0658 Performance improvement projects Standard
G0682 Infection Prevention Standard
G0687 COVID-19 Vaccination of Home Health Agency staff Standard
G0536 A review of all current medications Element
▼ 058290 Excellence Home Health Care Agency Inc 11760 Central Avenue Suite 200 Chino CA 9 (San Francisco) 04/05/2019 GZHN11 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
E0009 Local, State, Tribal Collaboration Process Standard
E0017 HHA Comprehensive Assessment in Disaster Standard
E0019 Homebound HHA/Hospice Inform EP Officials Standard
E0023 Policies/Procedures for Medical Documentation Standard
E0032 Primary/Alternate Means for Communication Standard
E0037 EP Training Program Standard
E0039 EP Testing Requirements Standard
G0572 Plan of care Standard
G0658 Performance improvement projects Standard
G0682 Infection Prevention Standard
G0684 Infection control Standard
G0726 Nursing services supervised by RN Element
▼ 058292 Hcc Healthcare At Home 6327 N Fresno St Suite 104 Fresno CA 9 (San Francisco) 08/09/2023 60942-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0572 Plan of care Standard
G0660 Executive responsibilities for QAPI Standard
▼ 058296 Excel Care Home Health Services Inc 222 N Mountain Avenue Suite 104 Upland CA 9 (San Francisco) 12/14/2023 61AED-H1 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
G0640 Quality assessment/performance improvement Condition
E0004 Develop EP Plan, Review and Update Annually Standard
E0009 Local, State, Tribal Collaboration Process Standard
E0019 Homebound HHA/Hospice Inform EP Officials Standard
E0024 Policies/Procedures-Volunteers and Staffing Standard
E0032 Primary/Alternate Means for Communication Standard
E0034 Information on Occupancy/Needs Standard
E0037 EP Training Program Standard
E0039 EP Testing Requirements Standard
G0642 Program scope Standard
G0644 Program data Standard
G0658 Performance improvement projects Standard
G0660 Executive responsibilities for QAPI Standard
G0942 Governing body Standard
G0514 RN performs assessment Element
▼ 058297 Cne Home Health Services, Inc 10600 Magnolia Avenue, Suite G Riverside CA 9 (San Francisco) 04/07/2022 387AD-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0536 A review of all current medications Element
G0710 Provide services in the plan of care Element