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
052638 Simi Valley Dialysis 970 Enchanted Way Simi Valley CA 9 (San Francisco) 11/22/2019 2UG611 Standard
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0111 Ic - Sanitary Environment Standard
V0115 Ic - Wear Gowns, Shields/Masks; Staff Not Eat/Drink In Tx Area Standard
V0121 Ic - Handling Infectious Waste Standard
V0122 Ic - Clean, Disinfect Surfaces & Equipment/Written Protocols Standard
V0143 Ic - Aseptic Techniques For Iv Meds Standard
V0403 Pe - Equipment Maintenance - Manufacturer'S Dfu Standard
V0407 Pe - Hemodialysis Patients In View During Treatments Standard
V0417 Pe-Fire Safety-Life Safety Code Standard
V0470 Rights Posted With State/Nw Contact #S And Addresses Standard
V0637 Qapi Indicator - Infection Control - Trend/Plan/Act Standard
V0726 Medical Records - Complete, Accurate, Accessible Standard
V0751 Identifiable Governing Body W/Full Authority/Responsibility Standard
052638 Simi Valley Dialysis 970 Enchanted Way Simi Valley CA 9 (San Francisco) 08/28/2024 WG8B11 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
V0121 Ic - Handling Infectious Waste Standard
V0401 Pe - Safe, Functional, Comfortable Environment Standard
V0503 Appropriateness Of Dialysis Rx Standard
V0504 Assess B/P & Fluid Management Needs Standard
V0543 Manage Volume Status Standard
V0544 Achieve Adequate Clearance Standard
V0550 Vascular Access - Monitor/Referrals Standard
052643 Tower Dialysis 8635 West Third St Ste 560 West Los Angeles CA 9 (San Francisco) 09/07/2018 KBWL11 Complaint
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0515 Eval Current Physical Activity Level & Voc/Physical Rehab Standard
V0520 Frequency Reassessment - Unstable - Monthly Standard
052643 Tower Dialysis 8635 West Third St Ste 560 West Los Angeles CA 9 (San Francisco) 10/18/2018 E49M11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
E0018 Procedures For Tracking Of Staff And Patients Standard
V0113 Ic - Wear Gloves/Hand Hygiene Standard
V0115 Ic - Wear Gowns, Shields/Masks; Staff Not Eat/Drink In Tx Area Standard
V0116 Ic - Items Taken To Station Disposed/Dedicated Or Disinfected Standard
V0124 Ic - Hbv - Test All Pts, Review Results/Pt Status Known Preadmit Standard
V0143 Ic - Aseptic Techniques For Iv Meds Standard
V0194 Carbon Adsorption - Iodine #900/Replacement Standard
V0195 Carbon Adsorption - 10 Minutes Ebct Standard
V0196 Carbon Adsorption - Monitoring, Testing Frequency Standard
V0229 Mixing Systems - Permanent Record/Verification Testing Standard
V0401 Pe - Safe, Functional, Comfortable Environment Standard
V0417 Pe-Fire Safety-Life Safety Code Standard
V0544 Achieve Adequate Clearance Standard
052644 Fresenius Medical Care Alhambra 2300 West Valley Blvd Alhambra CA 9 (San Francisco) 01/15/2019 DWZO11 Standard
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0113 Ic - Wear Gloves/Hand Hygiene Standard
V0114 Ic - Sinks Available Standard
V0117 Ic - Clean/Dirty Areas, Med Prep Area, No Common Med Carts Standard
V0122 Ic - Clean, Disinfect Surfaces & Equipment/Written Protocols Standard
V0178 Bacteriology Of Water-Maximum And Action Levels Standard
V0187 Environment - Schematic Diagrams/Labels Standard
V0197 Carbon Adsorption - Action If First Test Positive Standard
V0243 Bicarb Jugs Rinsed Daily/Stored Dry Standard
V0403 Pe - Equipment Maintenance - Manufacturer'S Dfu Standard
V0501 Patient Assessment - Interdisciplinary Team Mbrs/Resp. Standard
V0503 Appropriateness Of Dialysis Rx 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
V0726 Medical Records - Complete, Accurate, Accessible Standard
052647 Satellite Healthcare Turlock 1729 North Olive Ave, Suite 9 Turlock CA 9 (San Francisco) 01/29/2019 KI1V11 Complaint
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0403 Pe - Equipment Maintenance - Manufacturer'S Dfu Standard
V0681 Staff Licensed As Req/Qualified/Demonstrate Competencies Standard
052647 Satellite Healthcare Turlock 1729 North Olive Ave, Suite 9 Turlock CA 9 (San Francisco) 05/22/2019 503311 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0112 Ic - Cdc Mmwr 2001 Standard
V0115 Ic - Wear Gowns, Shields/Masks; Staff Not Eat/Drink In Tx Area Standard
V0503 Appropriateness Of Dialysis Rx Standard
052648 San Juan Capistrano South Dialysis 31736 Rancho Viejo Rd, Suite B & C San Juan Capistrano CA 9 (San Francisco) 02/08/2018 BBNL11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
E0028 Dialysis Emergency Equipment Standard
V0000 Initial Comments - Not A Deficiency Citation Memo
V0111 Ic - Sanitary Environment 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
V0143 Ic - Aseptic Techniques For Iv Meds Standard
V0196 Carbon Adsorption - Monitoring, Testing Frequency Standard
V0407 Pe - Hemodialysis Patients In View During Treatments Standard
V0543 Manage Volume Status Standard
V0544 Achieve Adequate Clearance Standard
V0715 Md Resp - Ensure All Adhere To P&P Standard
V0726 Medical Records - Complete, Accurate, Accessible Standard
052651 Us Renal Care Berkeley Dialysis 2895 7th Street Berkeley CA 9 (San Francisco) 06/07/2018 XFV911 Complaint
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0111 Ic - Sanitary Environment Standard
V0112 Ic - Cdc Mmwr 2001 Standard
V0511 Dialysis Access Type & Maintenance Standard
V0684 Nurse Manager - 12 Mo Rn + 6 Mo Dialysis Standard
V0752 Appoint Ceo/Administrator Standard
052651 Us Renal Care Berkeley Dialysis 2895 7th Street Berkeley CA 9 (San Francisco) 06/08/2018 OYPK11 Complaint
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0452 Respect & Dignity Standard