Facility Site Review
A Facility Site Review (FSR) is a physical assessment of a primary care practice site, including:
- Office management.
- Clinical services.
- Preventive services.
- Infection control.
The review evaluates:
- Infection prevention protocol.
- Medical and non-medical emergency preparedness.
- Operational protocols.
DHCS FSR Survey Tools and Standards
- CCAH Policy 401-1508: Facility Site Review Process.
- CCAH FSR site checklist.
- Non-physician medical practitioner.
- Changes to the Physician Assistant Act dated 01/01/2020 and delegations of services changed to 'Practice Agreement” SB-697.
- Orientation/training checklist with list of required training and skills.
- Minor’s rights statement and documentation of self-sufficient minor status.
- Office management:
- Preventive services: American Academy of Pediatrics (AAP)/Bright Futures periodicity schedule.
- Infection control: spore testing job aid.
Contact Provider Services
Contact the Site Review Team
- Phone: 831-430-2622
- Fax: 831-430-5890; “Attention: Facility Site Review Team”
- Email: firstname.lastname@example.org
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