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
052560 San Pablo Dialysis 13352 San Pablo Avenue San Pablo CA 9 (San Francisco) 01/10/2020 WHGC11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
E0036 Ep Training And Testing Standard
V0000 Initial Comments - Not A Deficiency Citation Memo
V0110 Cfc - Infection Control Condition
V0111 Ic - Sanitary Environment Standard
V0113 Ic - Wear Gloves/Hand Hygiene Standard
V0115 Ic - Wear Gowns, Shields/Masks; Staff Not Eat/Drink In Tx Area Standard
V0117 Ic - Clean/Dirty Areas, Med Prep Area, No Common Med Carts Standard
V0122 Ic - Clean, Disinfect Surfaces & Equipment/Written Protocols 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
V0407 Pe - Hemodialysis Patients In View During Treatments Standard
V0504 Assess B/P & Fluid Management Needs Standard
V0543 Manage Volume Status Standard
V0544 Achieve Adequate Clearance Standard
V0562 Patient/Family Education & Training Standard
052560 San Pablo Dialysis 13352 San Pablo Avenue San Pablo CA 9 (San Francisco) 03/05/2020 WHGC12 Standard
Deficiency Tag Deficiency Description Tag Type
V0116 Ic - Items Taken To Station Disposed/Dedicated Or Disinfected Standard
V0147 Ic - Staff Education Re Catheters/Catheter Care Standard
052560 San Pablo Dialysis 13352 San Pablo Avenue San Pablo CA 9 (San Francisco) 11/16/2020 5GRF11 Complaint
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0715 Md Resp - Ensure All Adhere To P&P Standard
V0765 Internal Grievance Process Components & Implemented Standard
052561 Victor Valley Dialysis 16049 Kamana Road Apple Valley CA 9 (San Francisco) 03/28/2018 3LPE11 Complaint
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0455 Privacy & Confidentiality In Records Standard
V0727 Mr - Protect Patient Records From Loss/Keep Confidential Standard
052563 Yuba City Dialysis Center 1525 Plumas Court, # A Yuba City CA 9 (San Francisco) 08/03/2023 9PUD11 Complaint
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
V0115 Ic - Wear Gowns, Shields/Masks; Staff Not Eat/Drink In Tx Area Standard
V0147 Ic - Staff Education Re Catheters/Catheter Care Standard
V0401 Pe - Safe, Functional, Comfortable Environment Standard
V0503 Appropriateness Of Dialysis Rx Standard
V0543 Manage Volume Status Standard
052563 Yuba City Dialysis Center 1525 Plumas Court, # A Yuba City CA 9 (San Francisco) 09/15/2023 9MYM11 Standard
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0113 Ic - Wear Gloves/Hand Hygiene Standard
V0120 Ic - Transducer Protectors: Not Wetted/Changed Standard
V0403 Pe - Equipment Maintenance - Manufacturer'S Dfu Standard
V0503 Appropriateness Of Dialysis Rx Standard
V0516 Frequency - Initial: 30 Days/13 Tx Standard
052564 Garfield Hemodialysis Center 118 Hilliard Avenue Monterey Park CA 9 (San Francisco) 10/04/2018 TYCI12 Complaint
Deficiency Tag Deficiency Description Tag Type
V0130 Ic - Hbv - Isolation Of Machines/Equipment/Supplies null
V0131 Ic - Hbv - Isolation - Staffing null
V0541 Patient Plan Of Care - Goals - Community-Based Standards null
052564 Garfield Hemodialysis Center 118 Hilliard Avenue Monterey Park CA 9 (San Francisco) 09/03/2019 VX7G11 Standard
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0113 Ic - Wear Gloves/Hand Hygiene Standard
V0122 Ic - Clean, Disinfect Surfaces & Equipment/Written Protocols Standard
V0196 Carbon Adsorption - Monitoring, Testing Frequency Standard
V0403 Pe - Equipment Maintenance - Manufacturer'S Dfu Standard
V0501 Patient Assessment - Interdisciplinary Team Mbrs/Resp. Standard
V0503 Appropriateness Of Dialysis Rx Standard
V0506 Immunization/Medication History Standard
V0516 Frequency - Initial: 30 Days/13 Tx Standard
V0519 Frequency Reassessment - Stable - Annual Standard
V0557 Initial Poc Implemented - 30 Days/13 Tx Standard
V0558 Implement Updates Of Poc - 15 Days P Pt Assessment Standard
V0715 Md Resp - Ensure All Adhere To P&P Standard
052564 Garfield Hemodialysis Center 118 Hilliard Avenue Monterey Park CA 9 (San Francisco) 06/03/2020 703B11 Complaint
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0455 Privacy & Confidentiality In Records Standard
052565 Silverado Dialysis 1100 Trancas St, Ste 266 & 267 Napa CA 9 (San Francisco) 01/31/2018 INB811 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
E0032 Primary/Alternate Means For Communication Standard
V0000 Initial Comments - Not A Deficiency Citation Memo
V0111 Ic - Sanitary Environment Standard
V0122 Ic - Clean, Disinfect Surfaces & Equipment/Written Protocols Standard
V0142 Ic - Oversight: Monitor Activities & Implement Policies Standard
V0401 Pe - Safe, Functional, Comfortable Environment Standard
V0407 Pe - Hemodialysis Patients In View During Treatments Standard
V0503 Appropriateness Of Dialysis Rx Standard
V0516 Frequency - Initial: 30 Days/13 Tx Standard