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
▼ 058451 Family Home Health Agency, Llc 1200 E Route 66 Suite 206a Glendora CA 9 (San Francisco) 04/28/2023 5FA19-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0572 Plan of care Standard
G0682 Infection Prevention Standard
G0702 Services by skilled professionals Standard
G0536 A review of all current medications Element
G0574 Plan of care must include the following Element
G0610 Patients receive education and training Element
G0616 Patient medication schedule/instructions Element
▼ 058451 Family Home Health Agency, Llc 1200 E Route 66 Suite 206a Glendora CA 9 (San Francisco) 10/27/2019 GY5111 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0572 Plan of care Standard
G0600 Coordination of Care Standard
G0710 Provide services in the plan of care Element
▼ 058469 A And E Home Health Services, Inc 2377 W Foothill Blvd Upland CA 9 (San Francisco) 02/12/2026 1E30F7-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
G0536 A review of all current medications Element
▼ 058469 A And E Home Health Services, Inc 2377 W Foothill Blvd Upland CA 9 (San Francisco) 02/09/2023 5EE22-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
E0004 Develop EP Plan, Review and Update Annually Standard
E0006 Plan Based on All Hazards Risk Assessment Standard
E0009 Local, State, Tribal Collaboration Process Standard
E0019 Homebound HHA/Hospice Inform EP Officials Standard
E0031 Emergency Officials Contact Information Standard
E0034 Information on Occupancy/Needs Standard
E0037 EP Training Program Standard
E0039 EP Testing Requirements Standard
G0518 Completion of the comprehensive assessment Standard
G0572 Plan of care Standard
G0642 Program scope Standard
G0644 Program data Standard
G0660 Executive responsibilities for QAPI Standard
G0682 Infection Prevention Standard
G0444 State toll free HH telephone hotline Element
G0514 RN performs assessment Element
G0536 A review of all current medications Element
G0584 Verbal orders Element
G0966 Assure patient needs are continually assessed Element
▼ 058476 Duhaney Home Health Care, Inc 6060 W Manchester Ave Suite 312 Los Angeles CA 9 (San Francisco) 06/23/2023 6021C-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0570 Care planning, coordination, quality of care Condition
G0940 Organization and administration of services Condition
E0004 Develop EP Plan, Review and Update Annually Standard
G0572 Plan of care Standard
G0600 Coordination of Care Standard
G0642 Program scope Standard
G0682 Infection Prevention Standard
G0942 Governing body Standard
G0944 Administrator must: Standard
G0536 A review of all current medications Element
G0580 Only as ordered by a physician Element
G1022 Discharge and transfer summaries Element
▼ 058477 Gibraltar Home Health Services Llc 22141 Ventura Blvd Suite 300 Woodland Hills CA 9 (San Francisco) 02/06/2026 1E2D30-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
G1008 Clinical records Condition
G0544 Update of the comprehensive assessment Standard
G0572 Plan of care Standard
G1024 Authentication Standard
G1028 Protection of records Standard
G0520 5 calendar days after start of care Element
G0528 Health, psychosocial, functional, cognition Element
G0536 A review of all current medications 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
G0588 Reviewed, revised by physician every 60 days Element
G0590 Promptly alert relevant physician of changes Element
G0710 Provide services in the plan of care Element
G0726 Nursing services supervised by RN Element
G1022 Discharge and transfer summaries Element
▼ 058477 Gibraltar Home Health Services Llc 22141 Ventura Blvd Suite 300 Woodland Hills CA 9 (San Francisco) 05/24/2023 5FDB5-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
G0526 Content of the comprehensive assessment Standard
G0572 Plan of care Standard
G1024 Authentication Standard
G0536 A review of all current medications Element
G0580 Only as ordered by a physician Element
G0952 Ensure that HHA employs qualified personnel Element
▼ 058477 Gibraltar Home Health Services Llc 22141 Ventura Blvd Suite 300 Woodland Hills CA 9 (San Francisco) 07/22/2021 BVZQ11 Complaint, Sample Validation
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0700 Skilled professional services Condition
G0940 Organization and administration of services Condition
G0710 Provide services in the plan of care Element
G0952 Ensure that HHA employs qualified personnel Element
▼ 058479 St. George Health Care, Inc. 1850 Gateway Blvd., Ste. 225 Concord CA 9 (San Francisco) 05/01/2025 65FD8-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0570 Care planning, coordination, quality of care Condition
G1008 Clinical records Condition
G0774 12 hours inservice every 12 months Standard
G0436 Receive all services in plan of care Element
G0580 Only as ordered by a physician Element
G0590 Promptly alert relevant physician of changes Element
G0606 Integrate all services Element
G0984 In accordance with current clinical practice Element
G1012 Required items in clinical record Element
▼ 058479 St. George Health Care, Inc. 1850 Gateway Blvd., Ste. 225 Concord CA 9 (San Francisco) 02/17/2022 3850B-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0572 Plan of care Standard
G0608 Coordinate care delivery Element
G0614 Visit schedule Element