S&C QCOR HHA 2567s
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HHAs 2567s
Selection Criteria ▸

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
▼ 058301 Bueno And Sons, Inc 924 Buena Vista St. Suite 102 Duarte CA 9 (San Francisco) 04/21/2023 5F925-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G1028 Protection of records Standard
G0536 A review of all current medications Element
G0722 Participate in HHA-sponsored in-service Element
G0772 Documentation of competency evaluation Element
▼ 058301 Bueno And Sons, Inc 924 Buena Vista St. Suite 102 Duarte CA 9 (San Francisco) 02/21/2020 TTYQ11 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0536 A review of all current medications Element
▼ 058303 Montrose Home Healthcare, Inc 230 N Maryland Avenue, Suite 104 Glendale CA 9 (San Francisco) 04/30/2023 5FAAB-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
G0682 Infection Prevention Standard
G0684 Infection control Standard
G0514 RN performs assessment Element
G0536 A review of all current medications Element
G0590 Promptly alert relevant physician of changes Element
G0610 Patients receive education and training Element
▼ 058303 Montrose Home Healthcare, Inc 230 N Maryland Avenue, Suite 104 Glendale CA 9 (San Francisco) 11/03/2019 XZIS11 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
▼ 058313 A's Home Health Care, Inc 11030 Arrow Route, Suite 202 Rancho Cucamonga CA 9 (San Francisco) 04/26/2023 5F94C-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0520 5 calendar days after start of care Element
G0574 Plan of care must include the following Element
▼ 058313 A's Home Health Care, Inc 11030 Arrow Route, Suite 202 Rancho Cucamonga CA 9 (San Francisco) 01/18/2023 5E960-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0572 Plan of care Standard
G0520 5 calendar days after start of care Element
G0550 At discharge Element
G0580 Only as ordered by a physician Element
G0716 Preparing clinical notes Element
▼ 058314 Eden Home Health Of Elk Grove, Llc 9299 E Stockton Blvd, Suite 10 Elk Grove CA 9 (San Francisco) 12/05/2019 S47C11 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0682 Infection Prevention Standard
G0580 Only as ordered by a physician Element
G0710 Provide services in the plan of care Element
G0800 Services provided by HH aide Element
▼ 058314 Eden Home Health Of Elk Grove, Llc 9299 E Stockton Blvd, Suite 10 Elk Grove CA 9 (San Francisco) 07/05/2019 1LTY11 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0572 Plan of care Standard
▼ 058321 Comprehensive Health Care, Inc 3440 Wilshire Blvd, Ste 1108 Los Angeles CA 9 (San Francisco) 01/25/2022 3836C-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
G0574 Plan of care must include the following Element
G0710 Provide services in the plan of care Element
▼ 058321 Comprehensive Health Care, Inc 3440 Wilshire Blvd, Ste 1108 Los Angeles CA 9 (San Francisco) 01/24/2022 38428-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0452 Transfer and discharge Standard