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PRINTED: DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES STATEMENT OF DEFICIENCIES (X1) PROVIDER/SUPPLIER/CIA AND PLAN OF CORRECTION IDENTIFICATION NUMBER: 155683
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What is this visit was for?
This visit was for a routine inspection.
Who is required to file this visit was for?
The supervisor or designated manager is required to file this visit.
How to fill out this visit was for?
The visit should be filled out by providing details about the inspection findings and any corrective actions taken.
What is the purpose of this visit was for?
The purpose of this visit is to ensure compliance with safety regulations and standards.
What information must be reported on this visit was for?
Information such as date of inspection, areas inspected, findings, corrective actions, and signatures must be reported on this visit.
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