S&C QCOR ICF-IID 2567s
d QCOR:  Quality, Certification and Oversight Reports.
ICF-IID 2567s
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Time Interval

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Provider Characteristics

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Survey Type & Deficiency Tags

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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
▼ 55G800 Mclennan Avenue Home 12325 Mclennan Avenue Granada Hills CA 9 (San Francisco) 01/23/2025 9C8I11 Complaint, Recertification
Deficiency Tag Deficiency Description Tag Type
W0000 Initial comments - not a deficiency citation Memo
W0121 Services provided with outside sources Standard
W0185 Facility staffing Standard
W0390 Drug labeling Standard
W0466 Food and nutrition services Standard
▼ 55G800 Mclennan Avenue Home 12325 Mclennan Avenue Granada Hills CA 9 (San Francisco) 11/07/2024 4ES511 Complaint
Deficiency Tag Deficiency Description Tag Type
W0000 Initial comments - not a deficiency citation Memo
W0104 Governing body Standard
▼ 55G800 Mclennan Avenue Home 12325 Mclennan Avenue Granada Hills CA 9 (San Francisco) 05/10/2024 3Z2B11 Complaint
Deficiency Tag Deficiency Description Tag Type
W0000 Initial comments - not a deficiency citation Memo
W0187 Direct care staff Standard
▼ 55G800 Mclennan Avenue Home 12325 Mclennan Avenue Granada Hills CA 9 (San Francisco) 04/18/2024 RN9P11 Complaint
Deficiency Tag Deficiency Description Tag Type
W0000 Initial comments - not a deficiency citation Memo
W0108 Compliance w federal, state & local laws Standard
▼ 55G800 Mclennan Avenue Home 12325 Mclennan Avenue Granada Hills CA 9 (San Francisco) 02/12/2024 8BQF21 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
KS353 Sprinkler system - maintenance and testing Standard
KS363 Corridor - doors Standard
▼ 55G800 Mclennan Avenue Home 12325 Mclennan Avenue Granada Hills CA 9 (San Francisco) 02/07/2024 8BQF11 Recertification
Deficiency Tag Deficiency Description Tag Type
W0000 Initial comments - not a deficiency citation Memo
W0385 Drug storage and recordkeeping Standard
W0455 Infection control Standard
W0472 Meal services Standard
W0474 Meal services Standard
▼ 55G800 Mclennan Avenue Home 12325 Mclennan Avenue Granada Hills CA 9 (San Francisco) 03/17/2023 EA9F21 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial comments - not a deficiency citation Memo
K0000 Initial comments - not a deficiency citation Memo
E0030 Names and contact information Standard
KS345 Fire alarm system - testing and maintenance Standard
KS353 Sprinkler system - maintenance and testing Standard
KS363 Corridor - doors Standard
KS712 Fire drills Standard
▼ 55G800 Mclennan Avenue Home 12325 Mclennan Avenue Granada Hills CA 9 (San Francisco) 03/16/2023 EA9F11 Recertification
Deficiency Tag Deficiency Description Tag Type
W0000 Initial comments - not a deficiency citation Memo
W0104 Governing body Standard
W0454 Infection control Standard
W0460 Food and nutrition services Standard
▼ 55G800 Mclennan Avenue Home 12325 Mclennan Avenue Granada Hills CA 9 (San Francisco) 09/12/2022 TVA611 Complaint
Deficiency Tag Deficiency Description Tag Type
W0000 Initial comments - not a deficiency citation Memo
W0189 Staff training program Standard
▼ 55G800 Mclennan Avenue Home 12325 Mclennan Avenue Granada Hills CA 9 (San Francisco) 03/07/2022 E3UI21 Initial Certification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial comments - not a deficiency citation Memo
K0000 Initial comments - not a deficiency citation Memo
E0004 Develop ep plan, review and update annually Standard
KS321 Hazardous areas - enclosure Standard
KS341 Fire alarm system - installation Standard
KS345 Fire alarm system - testing and maintenance Standard
KS351 Sprinkler system - installation Standard
KS353 Sprinkler system - maintenance and testing Standard
KS363 Corridor - doors Standard