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Facility Site Review Survey Resources

A FSR (FSR-A) is a physical assessment of a primary care practice site that includes six areas: Accessibility/Safety; Personnel; Office Management; Clinical Services; Preventive Services; and Infection Control.
The review will include evaluation of procedures/practices, policies, accessibility, equipment, infection prevention protocol, medical and non-medical emergency preparedness, and some operational protocol.

DHCS FSR Survey Tools and Standards:

  1. DHCS FSR APL can be found here.
  2. DHCS FSR Standards can be found here.
  3. DHCS FSR Tool can be found here.
  4. Interim Monitoring Form can be found here.

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