S&C QCOR ICF-IID 2567s
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ICF-IID 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 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
▼ 55G797 Cg Estepa Care Home 2, Inc 12800 Thornberg Way Rancho Cordova CA 9 (San Francisco) 04/28/2026 22F43C-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
W0000 Initial comments - not a deficiency citation Memo
W0124 Protection of clients rights Standard
W0217 Individual program plan Standard
W0339 Nursing services Standard
W0382 Drug storage and recordkeeping Standard
W0460 Food and nutrition services Standard
▼ 55G797 Cg Estepa Care Home 2, Inc 12800 Thornberg Way Rancho Cordova CA 9 (San Francisco) 02/10/2026 FIMZ11 Complaint
Deficiency Tag Deficiency Description Tag Type
W0000 Initial comments - not a deficiency citation Memo
W0331 Nursing services Standard
▼ 55G797 Cg Estepa Care Home 2, Inc 12800 Thornberg Way Rancho Cordova CA 9 (San Francisco) 02/27/2025 0W4P21 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial comments - not a deficiency citation Memo
K0000 Initial comments - not a deficiency citation Memo
KS345 Fire alarm system - testing and maintenance Standard
KS347 Smoke detection Standard
KS353 Sprinkler system - maintenance and testing Standard
KS363 Corridor - doors Standard
KS712 Fire drills Standard
▼ 55G797 Cg Estepa Care Home 2, Inc 12800 Thornberg Way Rancho Cordova CA 9 (San Francisco) 02/25/2025 0W4P11 Recertification
Deficiency Tag Deficiency Description Tag Type
W0000 Initial comments - not a deficiency citation Memo
W0382 Drug storage and recordkeeping Standard
W0390 Drug labeling Standard
W0460 Food and nutrition services Standard
W0481 Menus Standard
▼ 55G797 Cg Estepa Care Home 2, Inc 12800 Thornberg Way Rancho Cordova CA 9 (San Francisco) 03/19/2024 7WDM21 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial comments - not a deficiency citation Memo
K0000 Initial comments - not a deficiency citation Memo
E0015 Subsistence needs for staff and patients Standard
E0030 Names and contact information Standard
E0034 Information on occupancy/needs Standard
E0035 Ltc and icf/iid sharing plan with patients Standard
KS351 Sprinkler system - installation Standard
KS711 Evacuation and relocation plan Standard
▼ 55G797 Cg Estepa Care Home 2, Inc 12800 Thornberg Way Rancho Cordova CA 9 (San Francisco) 03/12/2024 7WDM11 Recertification
Deficiency Tag Deficiency Description Tag Type
W0000 Initial comments - not a deficiency citation Memo
W0368 Drug administration Standard
W0371 Drug administration Standard
W0372 Drug administration Standard
W0382 Drug storage and recordkeeping Standard
▼ 55G797 Cg Estepa Care Home 2, Inc 12800 Thornberg Way Rancho Cordova CA 9 (San Francisco) 03/14/2023 F7XB21 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial comments - not a deficiency citation Memo
K0000 Initial comments - not a deficiency citation Memo
E0039 Ep testing requirements Standard
KS211 Means of egress - general Standard
KS222 Egress doors Standard
KS711 Evacuation and relocation plan Standard
KS712 Fire drills Standard
▼ 55G797 Cg Estepa Care Home 2, Inc 12800 Thornberg Way Rancho Cordova CA 9 (San Francisco) 03/07/2023 F7XB11 Recertification
Deficiency Tag Deficiency Description Tag Type
W0000 Initial comments - not a deficiency citation Memo
W0104 Governing body Standard
W0111 Client records Standard
W0124 Protection of clients rights Standard
W0128 Protection of clients rights Standard
W0226 Individual program plan Standard
W0259 Program monitoring & change Standard
W0323 Physician services Standard
W0339 Nursing services Standard
W0383 Drug storage and recordkeeping Standard
W0441 Evacuation drills Standard
W0442 Evacuation drills Standard
W0443 Evacuation drills Standard
W0444 Evacuation drills Standard
W0445 Evacuation drills Standard
W0447 Evacuation drills Standard
W0460 Food and nutrition services Standard
W0481 Menus Standard
▼ 55G797 Cg Estepa Care Home 2, Inc 12800 Thornberg Way Rancho Cordova CA 9 (San Francisco) 06/01/2021 OK3621 Initial Certification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial comments - not a deficiency citation Memo
K0000 Initial comments - not a deficiency citation Memo
E0006 Plan based on all hazards risk assessment Standard
E0026 Roles under a waiver declared by secretary Standard
E0037 Ep training program Standard
KS341 Fire alarm system - installation Standard
KS351 Sprinkler system - installation Standard
KS352 Sprinkler system - supervisory signals Standard
KS354 Sprinkler system - out of service Standard
▼ 55G797 Cg Estepa Care Home 2, Inc 12800 Thornberg Way Rancho Cordova CA 9 (San Francisco) 05/25/2021 OK3611 Initial Certification
Deficiency Tag Deficiency Description Tag Type
W0000 Initial comments - not a deficiency citation Memo
W0189 Staff training program Standard
W0315 Drug usage Standard
W0327 Physician services Standard
W0455 Infection control Standard
W0460 Food and nutrition services Standard