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
▼ 55G800 Mclennan Avenue Home 12325 Mclennan Avenue Granada Hills CA 9 (San Francisco) 02/11/2022 E3UI11 Initial Certification
Deficiency Tag Deficiency Description Tag Type
W0000 Initial comments - not a deficiency citation Memo
W0104 Governing body Standard
W0364 Drug regimen review Standard
W0455 Infection control Standard
▼ 55G800 Mclennan Avenue Home 12325 Mclennan Avenue Granada Hills CA 9 (San Francisco) 01/27/2022 5FHO11 Complaint
Deficiency Tag Deficiency Description Tag Type
W0000 Initial comments - not a deficiency citation Memo
W0455 Infection control Standard
▼ 55G801 Beechwood Division 7976 Beechwood Dr Rancho Cucamonga CA 9 (San Francisco) 03/26/2026 CZDU11 Complaint
Deficiency Tag Deficiency Description Tag Type
W0000 Initial comments - not a deficiency citation Memo
W0124 Protection of clients rights Standard
▼ 55G801 Beechwood Division 7976 Beechwood Dr Rancho Cucamonga CA 9 (San Francisco) 08/06/2025 8MT821 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial comments - not a deficiency citation Memo
K0000 Initial comments - not a deficiency citation Memo
KS500 Building services - other Standard
KS712 Fire drills Standard
▼ 55G801 Beechwood Division 7976 Beechwood Dr Rancho Cucamonga CA 9 (San Francisco) 07/29/2025 8MT811 Recertification
Deficiency Tag Deficiency Description Tag Type
W0000 Initial comments - not a deficiency citation Memo
W0137 Protection of clients rights Standard
▼ 55G801 Beechwood Division 7976 Beechwood Dr Rancho Cucamonga CA 9 (San Francisco) 01/29/2025 90MQ11 Complaint
Deficiency Tag Deficiency Description Tag Type
E0000 Initial comments - not a deficiency citation Memo
W0000 Initial comments - not a deficiency citation Memo
W0000 Initial comments - not a deficiency citation Memo
W0120 Services provided with outside sources Standard
W0121 Services provided with outside sources Standard
W0153 Staff treatment of clients Standard
W0445 Evacuation drills Standard
▼ 55G801 Beechwood Division 7976 Beechwood Dr Rancho Cucamonga CA 9 (San Francisco) 07/01/2024 4OW821 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial comments - not a deficiency citation Memo
K0000 Initial comments - not a deficiency citation Memo
KS347 Smoke detection Standard
KS712 Fire drills Standard
▼ 55G801 Beechwood Division 7976 Beechwood Dr Rancho Cucamonga CA 9 (San Francisco) 06/18/2024 4OW811 Recertification
Deficiency Tag Deficiency Description Tag Type
W0000 Initial comments - not a deficiency citation Memo
W0248 Individual program plan Standard
W0443 Evacuation drills Standard
▼ 55G801 Beechwood Division 7976 Beechwood Dr Rancho Cucamonga CA 9 (San Francisco) 06/07/2022 H97X21 Initial Certification
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
▼ 55G801 Beechwood Division 7976 Beechwood Dr Rancho Cucamonga CA 9 (San Francisco) 05/25/2022 H97X11 Initial Certification
Deficiency Tag Deficiency Description Tag Type
W0000 Initial comments - not a deficiency citation Memo
W0130 Protection of clients rights Standard
W0368 Drug administration Standard
W0382 Drug storage and recordkeeping Standard
W0385 Drug storage and recordkeeping Standard
W0386 Drug storage and recordkeeping Standard
W0455 Infection control Standard