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
052617 Rai - Garden Grove Blvd - Garden Grove 12555 Garden Grove Blvd #100 Garden Grove CA 9 (San Francisco) 01/25/2018 JVXF11 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
V0122 Ic - Clean, Disinfect Surfaces & Equipment/Written Protocols Standard
V0143 Ic - Aseptic Techniques For Iv Meds Standard
V0243 Bicarb Jugs Rinsed Daily/Stored Dry Standard
V0407 Pe - Hemodialysis Patients In View During Treatments Standard
V0543 Manage Volume Status Standard
V0544 Achieve Adequate Clearance Standard
V0550 Vascular Access - Monitor/Referrals Standard
V0715 Md Resp - Ensure All Adhere To P&P Standard
V0726 Medical Records - Complete, Accurate, Accessible Standard
052620 Hemet Dialysis Center 3050 West Florida Avenue Hemet CA 9 (San Francisco) 02/22/2021 CL3F11 Complaint
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0504 Assess B/P & Fluid Management Needs Standard
V0544 Achieve Adequate Clearance Standard
V0550 Vascular Access - Monitor/Referrals Standard
052620 Hemet Dialysis Center 3050 West Florida Avenue Hemet CA 9 (San Francisco) 04/18/2022 CBFQ11 Complaint
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0113 Ic - Wear Gloves/Hand Hygiene Standard
V0504 Assess B/P & Fluid Management Needs Standard
V0544 Achieve Adequate Clearance Standard
052621 Brea Dialysis Center 595 Tamarack Avenue Suite A Brea CA 9 (San Francisco) 04/18/2018 M6FK11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
E0023 Policies/Procedures For Medical Documentation Standard
E0028 Dialysis Emergency Equipment Standard
E0030 Names And Contact Information Standard
E0038 Esrd Ep Training Program Standard
V0000 Initial Comments - Not A Deficiency Citation Memo
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
V0132 Ic - Training And Education Standard
V0231 Acid Conc Mixing Sys - Empty Completely//Prevent Corrosion Standard
V0403 Pe - Equipment Maintenance - Manufacturer'S Dfu Standard
V0407 Pe - Hemodialysis Patients In View During Treatments Standard
V0470 Rights Posted With State/Nw Contact #S And Addresses Standard
V0543 Manage Volume Status Standard
V0544 Achieve Adequate Clearance Standard
V0559 Outcome Not Achieved - Adjust Poc Standard
V0715 Md Resp - Ensure All Adhere To P&P Standard
V0727 Mr - Protect Patient Records From Loss/Keep Confidential Standard
V0765 Internal Grievance Process Components & Implemented Standard
052621 Brea Dialysis Center 595 Tamarack Avenue Suite A Brea CA 9 (San Francisco) 12/10/2025 FMS911 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
052624 Fmc Of Petaluma 715 Southpoint Blvd, Suite A Petaluma CA 9 (San Francisco) 06/07/2018 5VTR11 Standard
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0111 Ic - Sanitary Environment Standard
V0116 Ic - Items Taken To Station Disposed/Dedicated Or Disinfected Standard
V0122 Ic - Clean, Disinfect Surfaces & Equipment/Written Protocols Standard
V0143 Ic - Aseptic Techniques For Iv Meds Standard
V0544 Achieve Adequate Clearance Standard
052628 Hanford Dialysis 402 West Eight Street Hanford CA 9 (San Francisco) 08/11/2020 XZOE11 Complaint
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0111 Ic - Sanitary Environment Standard
052629 Satellite Healthcare Watsonville 5 Nielson Street Watsonville CA 9 (San Francisco) 01/05/2018 PT2813 Standard
Deficiency Tag Deficiency Description Tag Type
V0142 Ic - Oversight: Monitor Activities & Implement Policies null
V0715 Md Resp - Ensure All Adhere To P&P null
052629 Satellite Healthcare Watsonville 5 Nielson Street Watsonville CA 9 (San Francisco) 06/20/2022 RZHC11 Complaint
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0400 Cfc - Physical Environment Condition
V0407 Pe - Hemodialysis Patients In View During Treatments Standard
V0625 Cfc - Quality Assessment & Performance Improvement Condition
V0634 Qapi Indicator - Medical Injuries/Errors Standard
V0715 Md Resp - Ensure All Adhere To P&P Standard
052630 Satellite Healthcare Santa Rosa 2301 Circadian Way, Suite C Santa Rosa CA 9 (San Francisco) 04/17/2018 HXN511 Standard
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0111 Ic - Sanitary Environment 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
V0142 Ic - Oversight: Monitor Activities & Implement Policies Standard
V0143 Ic - Aseptic Techniques For Iv Meds Standard
V0147 Ic - Staff Education Re Catheters/Catheter Care Standard
V0407 Pe - Hemodialysis Patients In View During Treatments Standard
V0452 Respect & Dignity Standard
V0502 Assess Current Health Status Inc Comorbids Standard
V0503 Appropriateness Of Dialysis Rx Standard
V0504 Assess B/P & Fluid Management Needs Standard
V0634 Qapi Indicator - Medical Injuries/Errors Standard
V0760 Gb - Responsible For Staff Oriented To Facility & Resp Standard