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
052407 Outpatient Services - Peritoneal Dialysis At Kais 27200 Iris Ave Moreno Valley CA 9 (San Francisco) 09/10/2019 SO3L11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0587 Fac Receive/Review Self Monitoring Data Every 2 Months Standard
052500 San Diego Dialysis Services, Inc 3960 Third Ave San Diego CA 9 (San Francisco) 02/22/2018 IBSS11 Standard
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0228 Mixing Systems - Labeling Standard
V0519 Frequency Reassessment - Stable - Annual Standard
V0758 Rn, Msw, & Rd Available To Meet Patient Needs Standard
052502 Kidney Dialysis Care Unit 3600 E Martin Luther King Jr Bld Lynwood CA 9 (San Francisco) 05/15/2018 DSB411 Complaint
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0452 Respect & Dignity Standard
052502 Kidney Dialysis Care Unit 3600 E Martin Luther King Jr Bld Lynwood CA 9 (San Francisco) 07/09/2018 M91Q11 Complaint
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0401 Pe - Safe, Functional, Comfortable Environment Standard
V0405 Pe - Comfortable Temperature Standard
052502 Kidney Dialysis Care Unit 3600 E Martin Luther King Jr Bld Lynwood CA 9 (San Francisco) 03/25/2019 TTT211 Complaint
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0147 Ic - Staff Education Re Catheters/Catheter Care Standard
V0638 Continuously Monitor/Take Action/Track/Sustain Improve Standard
V0681 Staff Licensed As Req/Qualified/Demonstrate Competencies Standard
V0694 Pct Training Program Content Standard
V0710 Cfc - Responsibilities Of The Medical Director Condition
V0714 Md Resp - Develop, Review& Approve P&P Standard
V0715 Md Resp - Ensure All Adhere To P&P Standard
V0725 Cfc - Medical Records Condition
V0726 Medical Records - Complete, Accurate, Accessible Standard
052505 Fullerton Dialysis 238 Orangefair Mall Fullerton CA 9 (San Francisco) 12/21/2022 3DB611 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
V0122 Ic - Clean, Disinfect Surfaces & Equipment/Written Protocols Standard
V0401 Pe - Safe, Functional, Comfortable Environment Standard
V0403 Pe - Equipment Maintenance - Manufacturer'S Dfu Standard
V0503 Appropriateness Of Dialysis Rx Standard
052513 Santa Barbara Community Dialysis Center 222 Pesetas Ln Santa Barbara CA 9 (San Francisco) 09/06/2019 7Z1411 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
E0028 Dialysis Emergency Equipment Standard
V0114 Ic - Sinks Available Standard
V0115 Ic - Wear Gowns, Shields/Masks; Staff Not Eat/Drink In Tx Area Standard
V0122 Ic - Clean, Disinfect Surfaces & Equipment/Written Protocols Standard
V0124 Ic - Hbv - Test All Pts, Review Results/Pt Status Known Preadmit Standard
V0401 Pe - Safe, Functional, Comfortable Environment Standard
V0403 Pe - Equipment Maintenance - Manufacturer'S Dfu Standard
052513 Santa Barbara Community Dialysis Center 222 Pesetas Ln Santa Barbara CA 9 (San Francisco) 05/28/2021 58J911 Complaint, 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
V0122 Ic - Clean, Disinfect Surfaces & Equipment/Written Protocols Standard
V0147 Ic - Staff Education Re Catheters/Catheter Care Standard
V0403 Pe - Equipment Maintenance - Manufacturer'S Dfu Standard
V0547 Manage Anemia/H/H Measured Monthly Standard
V0751 Identifiable Governing Body W/Full Authority/Responsibility Standard
052514 Satellite Healthcare Stevens Creek 4360 Stevens Creek Blvd, Suite A San Jose CA 9 (San Francisco) 12/19/2018 XSPP11 Complaint, Standard
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0122 Ic - Clean, Disinfect Surfaces & Equipment/Written Protocols Standard
V0124 Ic - Hbv - Test All Pts, Review Results/Pt Status Known Preadmit Standard
V0126 Ic - Hbv - Vaccinate Patients & Staff Standard
V0131 Ic - Hbv - Isolation - Staffing Standard
V0196 Carbon Adsorption - Monitoring, Testing Frequency Standard
V0715 Md Resp - Ensure All Adhere To P&P Standard
052515 U.S. Renal Care Los Alamitos Dialysis 3810 Katella Avenue Los Alamitos CA 9 (San Francisco) 04/19/2018 X5P811 Complaint
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0765 Internal Grievance Process Components & Implemented Standard