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
▼ 058385 St Luke's Home Health Services, Inc 6850 Lincoln Ave. Buena Park CA 9 (San Francisco) 05/20/2026 231C9A-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
E0006 Plan Based on All Hazards Risk Assessment Standard
E0029 Development of Communication Plan Standard
G0372 Encoding and transmitting OASIS Standard
G1024 Authentication Standard
G0536 A review of all current medications Element
G0580 Only as ordered by a physician Element
G0610 Patients receive education and training Element
G0716 Preparing clinical notes Element
G0948 Responsible for all day-to-day operations Element
▼ 058385 St Luke's Home Health Services, Inc 6850 Lincoln Ave. Buena Park CA 9 (San Francisco) 05/09/2023 5FADD-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
E0009 Local, State, Tribal Collaboration Process Standard
E0019 Homebound HHA/Hospice Inform EP Officials Standard
E0030 Names and Contact Information Standard
G0682 Infection Prevention Standard
G0684 Infection control Standard
G0798 Home health aide assignments and duties 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
G0574 Plan of care must include the following Element
G0608 Coordinate care delivery Element
G0610 Patients receive education and training Element
G0614 Visit schedule 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
▼ 058387 R & A Home Health Services, Inc 600 West Broadway Suite 210 Glendale CA 9 (San Francisco) 05/25/2023 5FDF9-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0510 Comprehensive Assessment of Patients Condition
G0570 Care planning, coordination, quality of care Condition
G0700 Skilled professional services Condition
G0518 Completion of the comprehensive assessment Standard
G0544 Update of the comprehensive assessment Standard
G0572 Plan of care Standard
G0574 Plan of care must include the following Element
G0580 Only as ordered by a physician Element
G0590 Promptly alert relevant physician of changes Element
G0710 Provide services in the plan of care Element
G0714 Patient and caregiver education Element
▼ 058390 Lifecare Home Health Services, Inc 540 E Foothill Blvd Suite 200 San Dimas CA 9 (San Francisco) 11/14/2022 5E3BB-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0572 Plan of care Standard
G0528 Health, psychosocial, functional, cognition Element
G0546 Last 5 days of every 60 days unless: Element
G0574 Plan of care must include the following Element
G0588 Reviewed, revised by physician every 60 days Element
G0606 Integrate all services Element
▼ 058390 Lifecare Home Health Services, Inc 540 E Foothill Blvd Suite 200 San Dimas CA 9 (San Francisco) 04/16/2019 HDPI11 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0480 Treatment or care Element
G0536 A review of all current medications Element
G0710 Provide services in the plan of care Element
▼ 058391 Braewood Home Health Inc 8215 Van Nuys Blvd #300-301 Van Nuys CA 9 (San Francisco) 12/12/2021 380CC-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0444 State toll free HH telephone hotline Element
G0536 A review of all current medications Element
G0710 Provide services in the plan of care Element
▼ 058391 Braewood Home Health Inc 8215 Van Nuys Blvd #300-301 Van Nuys CA 9 (San Francisco) 01/31/2019 GRNZ11 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0710 Provide services in the plan of care Element
▼ 058392 Calipso Home Health Care, Inc 16909 Parthenia St., Ste. 205 Northridge CA 9 (San Francisco) 02/23/2022 38562-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0682 Infection Prevention Standard
G0684 Infection control Standard
G0590 Promptly alert relevant physician of changes Element
G0598 Discharge plans communication Element
▼ 058401 Le Meilleur Health Care Services, Inc 15919 East Main Street La Puente CA 9 (San Francisco) 07/08/2019 NZM811 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0536 A review of all current medications Element
▼ 058403 California Home Health Specialist, Inc 18856 Amar Road, Suite 12 Walnut CA 9 (San Francisco) 05/09/2019 IYCX11 Recertification
Deficiency Tag Deficiency Description Tag Type
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