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
▼ 55G808 Momentum Agencies Ranch House 13655 Woodcock Ave Sylmar CA 9 (San Francisco) 04/18/2024 QBPT21 Initial Certification
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
KS353 Sprinkler system - maintenance and testing Standard
▼ 55G808 Momentum Agencies Ranch House 13655 Woodcock Ave Sylmar CA 9 (San Francisco) 04/17/2024 QBPT11 Initial Certification
Deficiency Tag Deficiency Description Tag Type
W0000 Initial comments - not a deficiency citation Memo
W0339 Nursing services Standard
▼ 55G809 Melvin Haber House 12840 Cactus Drive Desert Hot Springs CA 9 (San Francisco) 06/24/2026 2372E3-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
W0000 Initial comments - not a deficiency citation Memo
W0149 Staff treatment of clients Standard
W0368 Drug administration Standard
▼ 55G809 Melvin Haber House 12840 Cactus Drive Desert Hot Springs CA 9 (San Francisco) 01/13/2026 J7UC21 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial comments - not a deficiency citation Memo
K0000 Initial comments - not a deficiency citation Memo
KS300 Protection - other Standard
KS712 Fire drills Standard
▼ 55G809 Melvin Haber House 12840 Cactus Drive Desert Hot Springs CA 9 (San Francisco) 01/06/2026 J7UC11 Recertification
Deficiency Tag Deficiency Description Tag Type
W0000 Initial comments - not a deficiency citation Memo
W0263 Program monitoring & change Standard
W0339 Nursing services Standard
W0418 Client bedrooms Standard
W0454 Infection control Standard
▼ 55G809 Melvin Haber House 12840 Cactus Drive Desert Hot Springs CA 9 (San Francisco) 07/02/2025 L6GV11 Complaint
Deficiency Tag Deficiency Description Tag Type
W0000 Initial comments - not a deficiency citation Memo
W0368 Drug administration Standard
▼ 55G809 Melvin Haber House 12840 Cactus Drive Desert Hot Springs CA 9 (San Francisco) 05/19/2025 28UP11 Complaint
Deficiency Tag Deficiency Description Tag Type
W0000 Initial comments - not a deficiency citation Memo
W0127 Protection of clients rights Standard
▼ 55G809 Melvin Haber House 12840 Cactus Drive Desert Hot Springs CA 9 (San Francisco) 01/23/2025 4NTP21 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial comments - not a deficiency citation Memo
K0000 Initial comments - not a deficiency citation Memo
KS168 Building construction type and height Standard
KS712 Fire drills Standard
▼ 55G809 Melvin Haber House 12840 Cactus Drive Desert Hot Springs CA 9 (San Francisco) 01/03/2024 P82S21 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
E0039 Ep testing requirements Standard
KS211 Means of egress - general Standard
KS359 Sprinkler system - installation Standard
KS500 Building services - other Standard
KS712 Fire drills Standard
▼ 55G809 Melvin Haber House 12840 Cactus Drive Desert Hot Springs CA 9 (San Francisco) 01/30/2019 4J0D21 Other-Fed
Deficiency Tag Deficiency Description Tag Type
E0000 Initial comments - not a deficiency citation Memo
K0000 Initial comments - not a deficiency citation Memo
E0029 Development of communication plan Standard
E0036 Ep training and testing Standard