S&C QCOR HHA 2567s
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HHAs 2567s
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Time Interval

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Provider Characteristics

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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
▼ 059111 San Diego Home Health Care Services Inc 5050 Avenida Encinas Carlsbad CA 9 (San Francisco) 07/24/2025 1D1A19-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0682 Infection Prevention Standard
G0798 Home health aide assignments and duties Standard
G0574 Plan of care must include the following Element
G0584 Verbal orders Element
G0590 Promptly alert relevant physician of changes Element
G0614 Visit schedule Element
G0800 Services provided by HH aide Element
G0808 Onsite supervisory visit every 14 days Element
▼ 059111 San Diego Home Health Care Services Inc 5050 Avenida Encinas Carlsbad CA 9 (San Francisco) 09/23/2022 4F663-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0572 Plan of care Standard
G0682 Infection Prevention Standard
▼ 059111 San Diego Home Health Care Services Inc 5050 Avenida Encinas Carlsbad CA 9 (San Francisco) 10/17/2019 D03B11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
G0000 Initial Comments - Not a Deficiency Citation Memo
G0682 Infection Prevention Standard
G0470 Document efforts to resolve problems Element
G0584 Verbal orders Element
G0708 Development and evaluation of plan of care Element
G0948 Responsible for all day-to-day operations Element
▼ 059114 Elite Home Care, Inc 3807 Sierra Hwy Suite 207 Acton CA 9 (San Francisco) 09/13/2024 62F21-H2 Complaint
Deficiency Tag Deficiency Description Tag Type
G0520 5 calendar days after start of care Element
G0528 Health, psychosocial, functional, cognition Element
G0546 Last 5 days of every 60 days unless: Element
G0548 Within 48 hours of the patient's return Element
G0588 Reviewed, revised by physician every 60 days Element
G0592 Revised plan of care Element
▼ 059114 Elite Home Care, Inc 3807 Sierra Hwy Suite 207 Acton CA 9 (San Francisco) 05/03/2024 62F21-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
G0518 Completion of the comprehensive assessment Standard
G0526 Content of the comprehensive assessment Standard
G0612 Written instructions to patient include: Standard
G0682 Infection Prevention Standard
G0412 Written notice of patient's rights Element
G0536 A review of all current medications Element
G0574 Plan of care must include the following Element
G0616 Patient medication schedule/instructions Element
▼ 059117 Maxim Healthcare Services, Inc 1478 Stone Point Dr Roseville CA 9 (San Francisco) 06/27/2023 5FE02-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0570 Care planning, coordination, quality of care Condition
G0940 Organization and administration of services Condition
G0572 Plan of care Standard
G0590 Promptly alert relevant physician of changes Element
G0984 In accordance with current clinical practice Element
▼ 059119 Progressive Home Health Care, Inc 1314 W Glenoaks Blvd, Suite 204 Glendale CA 9 (San Francisco) 02/23/2020 5QRK11 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
E0017 HHA Comprehensive Assessment in Disaster Standard
G0572 Plan of care Standard
G0522 Eligibility for Medicare home health benefit Element
G0710 Provide services in the plan of care Element
▼ 059122 Tender Loving Care Health Care Services Western, Llc 1700 S Winchester Blvd, Suite 102 Campbell CA 9 (San Francisco) 11/27/2018 MG0M11 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0682 Infection Prevention Standard
G0460 Patient refuses services Element
G0536 A review of all current medications Element
G0580 Only as ordered by a physician Element
G0598 Discharge plans communication Element
G0710 Provide services in the plan of care Element
▼ 059126 Blue Sky Home Health Care, Inc 16501 Sherman Way, Suite 210 Van Nuys CA 9 (San Francisco) 05/18/2026 231DE5-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0510 Comprehensive Assessment of Patients Condition
G1008 Clinical records Condition
G0572 Plan of care Standard
G0612 Written instructions to patient include: Standard
G1024 Authentication Standard
G0514 RN performs assessment Element
G0536 A review of all current medications Element
G0616 Patient medication schedule/instructions Element
G1012 Required items in clinical record Element
G1022 Discharge and transfer summaries Element
▼ 059131 Klm Home Health, Incorporated 3111 Los Feliz Blvd Suite 100 Los Angeles CA 9 (San Francisco) 10/15/2019 GTJU11 Recertification
Deficiency Tag Deficiency Description Tag Type
G0000 Initial Comments - Not a Deficiency Citation Memo
G0710 Provide services in the plan of care Element