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
▼ 55G806 Discovering Horizons - Balboa House 8903 Balboa Blvd Northridge CA 9 (San Francisco) 11/08/2024 VBXV11 Recertification
Deficiency Tag Deficiency Description Tag Type
W0000 Initial comments - not a deficiency citation Memo
W0104 Governing body Standard
W0255 Program monitoring & change Standard
▼ 55G806 Discovering Horizons - Balboa House 8903 Balboa Blvd Northridge CA 9 (San Francisco) 11/07/2024 VBXV21 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial comments - not a deficiency citation Memo
K0000 Initial comments - not a deficiency citation Memo
KS362 Corridors - construction of walls Standard
▼ 55G806 Discovering Horizons - Balboa House 8903 Balboa Blvd Northridge CA 9 (San Francisco) 12/30/2023 GLID11 Initial Certification
Deficiency Tag Deficiency Description Tag Type
W0000 Initial comments - not a deficiency citation Memo
W0255 Program monitoring & change Standard
W0369 Drug administration Standard
W0388 Drug labeling Standard
W0455 Infection control Standard
W0460 Food and nutrition services Standard
▼ 55G807 Aces House 284 Moroni Avenue Lake Elsinore CA 9 (San Francisco) 03/06/2026 Y8JX11 Complaint
Deficiency Tag Deficiency Description Tag Type
W0000 Initial comments - not a deficiency citation Memo
W0331 Nursing services Standard
▼ 55G807 Aces House 284 Moroni Avenue Lake Elsinore CA 9 (San Francisco) 02/11/2026 RMLE11 Complaint
Deficiency Tag Deficiency Description Tag Type
W0000 Initial comments - not a deficiency citation Memo
W0122 Client protections Condition
W0104 Governing body Standard
W0128 Protection of clients rights Standard
W0129 Protection of clients rights Standard
W0382 Drug storage and recordkeeping Standard
W0454 Infection control Standard
▼ 55G807 Aces House 284 Moroni Avenue Lake Elsinore CA 9 (San Francisco) 02/05/2026 03A321 Recertification
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
KS345 Fire alarm system - testing and maintenance Standard
KS712 Fire drills Standard
▼ 55G807 Aces House 284 Moroni Avenue Lake Elsinore CA 9 (San Francisco) 01/28/2026 03A311 Recertification
Deficiency Tag Deficiency Description Tag Type
W0000 Initial comments - not a deficiency citation Memo
W0120 Services provided with outside sources Standard
W0130 Protection of clients rights Standard
W0388 Drug labeling Standard
W0454 Infection control Standard
W0483 Dining areas and service Standard
W0488 Dining areas and service Standard
▼ 55G807 Aces House 284 Moroni Avenue Lake Elsinore CA 9 (San Francisco) 10/30/2025 MV0X11 Complaint
Deficiency Tag Deficiency Description Tag Type
W0000 Initial comments - not a deficiency citation Memo
W0000 Initial comments - not a deficiency citation Memo
W0130 Protection of clients rights Standard
W0189 Staff training program Standard
W0268 Conduct toward client Standard
W0368 Drug administration Standard
W0440 Evacuation drills Standard
W0454 Infection control Standard
W0473 Meal services Standard
▼ 55G807 Aces House 284 Moroni Avenue Lake Elsinore CA 9 (San Francisco) 02/04/2025 HGUX21 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial comments - not a deficiency citation Memo
K0000 Initial comments - not a deficiency citation Memo
KS222 Egress doors Standard
KS345 Fire alarm system - testing and maintenance Standard
KS353 Sprinkler system - maintenance and testing Standard
KS511 Utilities - gas and electric Standard
KS711 Evacuation and relocation plan Standard
KS712 Fire drills Standard
▼ 55G807 Aces House 284 Moroni Avenue Lake Elsinore CA 9 (San Francisco) 01/28/2025 HGUX11 Recertification
Deficiency Tag Deficiency Description Tag Type
W0000 Initial comments - not a deficiency citation Memo
W0104 Governing body Standard
W0120 Services provided with outside sources Standard
W0249 Program implementation Standard
W0392 Drug labeling Standard
W0454 Infection control Standard
W0460 Food and nutrition services Standard