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
▼ 55G807 Aces House 284 Moroni Avenue Lake Elsinore CA 9 (San Francisco) 12/03/2024 7D1111 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) 02/28/2024 PEFM21 Initial Certification
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
KS351 Sprinkler system - installation Standard
▼ 55G807 Aces House 284 Moroni Avenue Lake Elsinore CA 9 (San Francisco) 02/21/2024 PEFM11 Initial Certification
Deficiency Tag Deficiency Description Tag Type
W0000 Initial comments - not a deficiency citation Memo
W0473 Meal services Standard
▼ 55G808 Momentum Agencies Ranch House 13655 Woodcock Ave Sylmar CA 9 (San Francisco) 03/19/2026 WHQK21 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial comments - not a deficiency citation Memo
K0000 Initial comments - not a deficiency citation Memo
E0007 Ep program patient population Standard
E0039 Ep testing requirements Standard
KA345 Fire alarm system - testing and maintenance Standard
KA353 Sprinkler system - maintenance & testing Standard
KA511 Utilities - gas and electric Standard
KA712 Fire drills Standard
▼ 55G808 Momentum Agencies Ranch House 13655 Woodcock Ave Sylmar CA 9 (San Francisco) 03/18/2026 WHQK11 Recertification
Deficiency Tag Deficiency Description Tag Type
W0000 Initial comments - not a deficiency citation Memo
W0339 Nursing services Standard
W0386 Drug storage and recordkeeping Standard
▼ 55G808 Momentum Agencies Ranch House 13655 Woodcock Ave Sylmar CA 9 (San Francisco) 03/02/2026 DU3Q11 Complaint
Deficiency Tag Deficiency Description Tag Type
W0000 Initial comments - not a deficiency citation Memo
W0369 Drug administration Standard
▼ 55G808 Momentum Agencies Ranch House 13655 Woodcock Ave Sylmar CA 9 (San Francisco) 05/14/2025 1OU211 Complaint
Deficiency Tag Deficiency Description Tag Type
W0000 Initial comments - not a deficiency citation Memo
W0164 Professional program services Standard
W0206 Individual program plan Standard
W0313 Drug usage Standard
▼ 55G808 Momentum Agencies Ranch House 13655 Woodcock Ave Sylmar CA 9 (San Francisco) 04/11/2025 VE7F11 Complaint
Deficiency Tag Deficiency Description Tag Type
W0000 Initial comments - not a deficiency citation Memo
W0341 Nursing services Standard
W0381 Drug storage and recordkeeping Standard
▼ 55G808 Momentum Agencies Ranch House 13655 Woodcock Ave Sylmar CA 9 (San Francisco) 03/13/2025 VGRQ21 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial comments - not a deficiency citation Memo
K0000 Initial comments - not a deficiency citation Memo
E0024 Policies/procedures-volunteers and staffing Standard
KS353 Sprinkler system - maintenance and testing Standard
KS712 Fire drills Standard
KS751 Draperies, curtains, and loosely hanging fabr Standard
▼ 55G808 Momentum Agencies Ranch House 13655 Woodcock Ave Sylmar CA 9 (San Francisco) 03/12/2025 VGRQ11 Complaint, Recertification
Deficiency Tag Deficiency Description Tag Type
W0000 Initial comments - not a deficiency citation Memo
W0104 Governing body Standard
W0322 Physician services Standard