S&C QCOR ESRD 2567s
d QCOR:  Quality, Certification and Oversight Reports.
ESRDs 2567s
Selection Criteria

Time Interval

Please select the calendar year or years for which you would like data.

Note: There is currently no ESRD 2567 data available past Feb 19, 2026 due to data system migrations.

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 ESRD 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
052793 Satellite Healthcare San Carlos 1125 Industrial Road, Suite G San Carlos CA 9 (San Francisco) 02/27/2019 E4WV11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0113 Ic - Wear Gloves/Hand Hygiene Standard
V0401 Pe - Safe, Functional, Comfortable Environment Standard
V0503 Appropriateness Of Dialysis Rx Standard
052794 Trc Usc Kidney Center 2310 Alcazar Street Los Angeles CA 9 (San Francisco) 12/10/2025 9TX711 Complaint
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0518 Assess Hd Adequacy Monthly/Pd Adequacy Q 4 Months Standard
052796 Madison Dialysis Clinic 5222 Madison Avenue Sacramento CA 9 (San Francisco) 04/14/2020 ID2E11 Special
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0113 Ic - Wear Gloves/Hand Hygiene Standard
V0119 Ic - Supply Cart Distant/No Supplies In Pockets Standard
V0122 Ic - Clean, Disinfect Surfaces & Equipment/Written Protocols Standard
V0147 Ic - Staff Education Re Catheters/Catheter Care Standard
V0402 Pe - Building - Constructed/Maintained To Ensure Safety Standard
V0403 Pe - Equipment Maintenance - Manufacturer'S Dfu Standard
V0556 Poc Completed/Signed By Idt & Patient Standard
052797 Bio Medical Applications Arden 37478 Cedar Blvd Unit A Newark CA 9 (San Francisco) 12/12/2019 4DQH11 Standard
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0110 Cfc - Infection Control Condition
V0111 Ic - Sanitary Environment Standard
V0112 Ic - Cdc Mmwr 2001 Standard
V0113 Ic - Wear Gloves/Hand Hygiene Standard
V0116 Ic - Items Taken To Station Disposed/Dedicated Or Disinfected Standard
V0122 Ic - Clean, Disinfect Surfaces & Equipment/Written Protocols Standard
V0127 Ic - Hbv - Test Pts/Staff Post Last Dose Standard
V0147 Ic - Staff Education Re Catheters/Catheter Care Standard
V0401 Pe - Safe, Functional, Comfortable Environment Standard
V0403 Pe - Equipment Maintenance - Manufacturer'S Dfu Standard
V0466 Informed - External Grievance Processes Standard
V0715 Md Resp - Ensure All Adhere To P&P Standard
V0727 Mr - Protect Patient Records From Loss/Keep Confidential Standard
052800 Santa Paula Dialysis 253 March St Santa Paula CA 9 (San Francisco) 10/31/2019 LHB011 Standard
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0111 Ic - Sanitary Environment Standard
V0143 Ic - Aseptic Techniques For Iv Meds Standard
V0681 Staff Licensed As Req/Qualified/Demonstrate Competencies Standard
V0726 Medical Records - Complete, Accurate, Accessible Standard
052800 Santa Paula Dialysis 253 March St Santa Paula CA 9 (San Francisco) 05/14/2021 3EFZ11 Complaint
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0400 Cfc - Physical Environment Condition
V0403 Pe - Equipment Maintenance - Manufacturer'S Dfu Standard
V0502 Assess Current Health Status Inc Comorbids Standard
V0519 Frequency Reassessment - Stable - Annual Standard
052801 Hollywood Dialysis Center 5108 Sunset Blvd Los Angeles CA 9 (San Francisco) 05/01/2023 QU2911 Complaint
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0502 Assess Current Health Status Inc Comorbids Standard
052802 Trc Harbor Ucla Mfi Total Rena 21600 South Vermont Avenue Torrance CA 9 (San Francisco) 08/25/2022 20WW11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0114 Ic - Sinks Available Standard
052803 Carson Dialysis 1309 East Carson Street Carson CA 9 (San Francisco) 07/07/2023 0EAV11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0113 Ic - Wear Gloves/Hand Hygiene Standard
V0401 Pe - Safe, Functional, Comfortable Environment Standard
V0402 Pe - Building - Constructed/Maintained To Ensure Safety Standard
V0403 Pe - Equipment Maintenance - Manufacturer'S Dfu Standard
V0503 Appropriateness Of Dialysis Rx Standard
V0765 Internal Grievance Process Components & Implemented Standard
052804 Montclair Dialysis Center 9142 Monte Vista Ave Montclair CA 9 (San Francisco) 12/20/2019 8FR211 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0111 Ic - Sanitary Environment Standard
V0113 Ic - Wear Gloves/Hand Hygiene Standard
V0403 Pe - Equipment Maintenance - Manufacturer'S Dfu Standard
V0407 Pe - Hemodialysis Patients In View During Treatments Standard
V0751 Identifiable Governing Body W/Full Authority/Responsibility Standard