S&C QCOR ICF-IID 2567s
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ICF-IID 2567s
Selection Criteria ▸

Time Interval

Please select the calendar year or years for which you would like data.

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 ICF-IID 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
▼ 03G008 Hacienda De Los Angeles 1402 East South Mountain Avenue Phoenix AZ 9 (San Francisco) 08/26/2025 K31311 Complaint
Deficiency Tag Deficiency Description Tag Type
W0000 Initial comments - not a deficiency citation Memo
W0127 Protection of clients rights Standard
W0193 Staff training program Standard
W0254 Program documentation Standard
▼ 03G008 Hacienda De Los Angeles 1402 East South Mountain Avenue Phoenix AZ 9 (San Francisco) 05/07/2025 FXYR11 Complaint
Deficiency Tag Deficiency Description Tag Type
W0000 Initial comments - not a deficiency citation Memo
W0183 Facility staffing Standard
▼ 03G008 Hacienda De Los Angeles 1402 East South Mountain Avenue Phoenix AZ 9 (San Francisco) 04/23/2025 ZIV811 Complaint
Deficiency Tag Deficiency Description Tag Type
W0000 Initial comments - not a deficiency citation Memo
W0000 Initial comments - not a deficiency citation Memo
W0150 Staff treatment of clients Standard
W0183 Facility staffing Standard
W0249 Program implementation Standard
▼ 03G008 Hacienda De Los Angeles 1402 East South Mountain Avenue Phoenix AZ 9 (San Francisco) 04/11/2025 VPCV11 Complaint
Deficiency Tag Deficiency Description Tag Type
W0000 Initial comments - not a deficiency citation Memo
W0183 Facility staffing Standard
▼ 03G008 Hacienda De Los Angeles 1402 East South Mountain Avenue Phoenix AZ 9 (San Francisco) 04/07/2025 P2LA21 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial comments - not a deficiency citation Memo
K0000 Initial comments - not a deficiency citation Memo
K0363 Corridor - doors Standard
▼ 03G008 Hacienda De Los Angeles 1402 East South Mountain Avenue Phoenix AZ 9 (San Francisco) 03/31/2025 BLUG11 Complaint
Deficiency Tag Deficiency Description Tag Type
W0000 Initial comments - not a deficiency citation Memo
W0149 Staff treatment of clients Standard
W0153 Staff treatment of clients Standard
W0154 Staff treatment of clients Standard
▼ 03G008 Hacienda De Los Angeles 1402 East South Mountain Avenue Phoenix AZ 9 (San Francisco) 03/13/2025 P2LA11 Complaint, Recertification
Deficiency Tag Deficiency Description Tag Type
W0000 Initial comments - not a deficiency citation Memo
W0150 Staff treatment of clients Standard
W0322 Physician services Standard
W0341 Nursing services Standard
W0445 Evacuation drills Standard
W0454 Infection control Standard
▼ 03G008 Hacienda De Los Angeles 1402 East South Mountain Avenue Phoenix AZ 9 (San Francisco) 10/30/2024 DKE711 Complaint
Deficiency Tag Deficiency Description Tag Type
W0000 Initial comments - not a deficiency citation Memo
W0339 Nursing services Standard
▼ 03G008 Hacienda De Los Angeles 1402 East South Mountain Avenue Phoenix AZ 9 (San Francisco) 08/27/2024 B8Y111 Complaint
Deficiency Tag Deficiency Description Tag Type
W0000 Initial comments - not a deficiency citation Memo
W0183 Facility staffing Standard
W0251 Program implementation Standard
▼ 03G008 Hacienda De Los Angeles 1402 East South Mountain Avenue Phoenix AZ 9 (San Francisco) 01/19/2024 R0XI11 Complaint
Deficiency Tag Deficiency Description Tag Type
W0000 Initial comments - not a deficiency citation Memo
W0249 Program implementation Standard