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
▼ 059025 Sanrose Home Health Services, Inc 41865 Boardwalk Ste 206 Palm Desert CA 9 (San Francisco) 01/31/2019 GYNK11 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0572 Plan of care Standard
▼ 059026 Affinity Home Health Care Services, Inc 6960 Magnolia Ave, Suite 201 Riverside CA 9 (San Francisco) 08/02/2024 63B35-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0528 Health, psychosocial, functional, cognition Element
G0536 A review of all current medications Element
G0984 In accordance with current clinical practice Element
▼ 059026 Affinity Home Health Care Services, Inc 6960 Magnolia Ave, Suite 201 Riverside CA 9 (San Francisco) 05/24/2019 YQN811 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0682 Infection Prevention Standard
G0686 Infection control education Standard
G0530 Strengths, goals, and care preferences Element
G0536 A review of all current medications Element
G0608 Coordinate care delivery Element
▼ 059032 Angels On Earth Home Health Inc 4959 Palo Verde St#201a Montclair CA 9 (San Francisco) 11/22/2024 64AE9-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0680 Infection prevention and control Condition
G0572 Plan of care Standard
G0682 Infection Prevention Standard
G0862 Laboratory services/CLIA waivers Standard
G0514 RN performs assessment Element
G0536 A review of all current medications Element
G0580 Only as ordered by a physician Element
G0590 Promptly alert relevant physician of changes Element
▼ 059040 Star World Home Health Care Services, Inc. 7400 Van Nuys Blvd, Suite 240 Van Nuys CA 9 (San Francisco) 11/18/2020 O5UV11 Complaint, Sample Validation
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0536 A review of all current medications Element
G0574 Plan of care must include the following Element
G0610 Patients receive education and training Element
G0800 Services provided by HH aide Element
G0804 Aides are members of interdisciplinary team Element
▼ 059044 Advance Healthlink, Inc 2490 Honolulu Ave., Ste. 120 Montrose CA 9 (San Francisco) 09/04/2019 VYI011 Complaint, Sample Validation
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0570 Care planning, coordination, quality of care Condition
G0580 Only as ordered by a physician Element
G0980 Primary HHA is responsible for patient care Element
▼ 059048 Homeliving Health Providers, Inc 18321 Ventura Blvd, Suite 780 Tarzana CA 9 (San Francisco) 11/01/2024 648EB-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0406 Condition of Participation: Patient rights. Condition
G0572 Plan of care Standard
G0860 Licensing Standard
G0478 Investigate complaints made by patient Element
G0488 Immediate reporting of abuse by all staff Element
▼ 059049 Valley Home Health Care Agency, Inc 5530 Corbin Avenue, Suite 112 Tarzana CA 9 (San Francisco) 04/22/2021 FHT411 Complaint, Sample Validation
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0940 Organization and administration of services Condition
G0572 Plan of care Standard
G0944 Administrator must: Standard
G0574 Plan of care must include the following Element
G0946 Administrator appointed by governing body Element
G0954 Ensures qualified pre-designated person Element
▼ 059050 Renaissance Home Health Services 512 E. Wilson Ave. Suite 203 Glendale CA 9 (San Francisco) 02/19/2023 5EF5B-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0572 Plan of care Standard
G0684 Infection control Standard
G0686 Infection control education Standard
G0536 A review of all current medications Element
G0580 Only as ordered by a physician Element
G0610 Patients receive education and training Element
G0714 Patient and caregiver education Element
▼ 059050 Renaissance Home Health Services 512 E. Wilson Ave. Suite 203 Glendale CA 9 (San Francisco) 08/01/2019 NMPN11 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0710 Provide services in the plan of care Element