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
▼ 55G804 Lorane Way 1592 W Lorane Way Anaheim CA 9 (San Francisco) 09/11/2024 KPPM11 Complaint
Deficiency Tag Deficiency Description Tag Type
W0000 Initial comments - not a deficiency citation Memo
W0342 Nursing services Standard
▼ 55G804 Lorane Way 1592 W Lorane Way Anaheim CA 9 (San Francisco) 09/03/2024 PESK11 Complaint
Deficiency Tag Deficiency Description Tag Type
W0000 Initial comments - not a deficiency citation Memo
W0120 Services provided with outside sources Standard
W0289 Mgmt of inappropriate client behavior Standard
W0325 Physician services Standard
W0331 Nursing services Standard
W0339 Nursing services Standard
▼ 55G804 Lorane Way 1592 W Lorane Way Anaheim CA 9 (San Francisco) 04/18/2024 ZUX621 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
KS345 Fire alarm system - testing and maintenance Standard
KS363 Corridor - doors Standard
KS511 Utilities - gas and electric Standard
▼ 55G804 Lorane Way 1592 W Lorane Way Anaheim CA 9 (San Francisco) 04/10/2024 ZUX611 Complaint, Recertification
Deficiency Tag Deficiency Description Tag Type
W0000 Initial comments - not a deficiency citation Memo
W0196 Active treatment Standard
W0252 Program documentation Standard
W0323 Physician services Standard
W0339 Nursing services Standard
W0342 Nursing services Standard
W0392 Drug labeling Standard
W0454 Infection control Standard
W0460 Food and nutrition services Standard
W0472 Meal services Standard
▼ 55G804 Lorane Way 1592 W Lorane Way Anaheim CA 9 (San Francisco) 12/29/2023 N3XV11 Complaint
Deficiency Tag Deficiency Description Tag Type
W0000 Initial comments - not a deficiency citation Memo
W0104 Governing body Standard
▼ 55G804 Lorane Way 1592 W Lorane Way Anaheim CA 9 (San Francisco) 02/27/2023 X4SE11 Complaint
Deficiency Tag Deficiency Description Tag Type
W0000 Initial comments - not a deficiency citation Memo
W0102 Governing body and management Condition
W0318 Health care services Condition
W0104 Governing body Standard
W0124 Protection of clients rights Standard
W0137 Protection of clients rights Standard
W0315 Drug usage Standard
W0327 Physician services Standard
W0331 Nursing services Standard
W0339 Nursing services Standard
W0361 Pharmacy services Standard
W0368 Drug administration Standard
W0435 Space and equipment Standard
▼ 55G804 Lorane Way 1592 W Lorane Way Anaheim CA 9 (San Francisco) 02/23/2023 XZLM11 Complaint
Deficiency Tag Deficiency Description Tag Type
W0000 Initial comments - not a deficiency citation Memo
W0325 Physician services Standard
W0331 Nursing services Standard
▼ 55G804 Lorane Way 1592 W Lorane Way Anaheim CA 9 (San Francisco) 07/20/2022 6IDN21 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
E0007 Ep program patient population Standard
E0015 Subsistence needs for staff and patients Standard
E0022 Policies/procedures for sheltering in place Standard
E0024 Policies/procedures-volunteers and staffing Standard
E0026 Roles under a waiver declared by secretary Standard
E0029 Development of communication plan Standard
E0031 Emergency officials contact information Standard
E0037 Ep training program Standard
KS222 Egress doors Standard
KS351 Sprinkler system - installation Standard
KS511 Utilities - gas and electric Standard
▼ 55G806 Discovering Horizons - Balboa House 8903 Balboa Blvd Northridge CA 9 (San Francisco) 10/30/2025 D4T011 Complaint, Recertification
Deficiency Tag Deficiency Description Tag Type
W0000 Initial comments - not a deficiency citation Memo
W0189 Staff training program Standard
W0196 Active treatment Standard
▼ 55G806 Discovering Horizons - Balboa House 8903 Balboa Blvd Northridge CA 9 (San Francisco) 10/29/2025 D4T021 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial comments - not a deficiency citation Memo
K0000 Initial comments - not a deficiency citation Memo
KS761 Maintenance, inspection and testing - doors Standard