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PRINTED: DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES STATEMENT OF DEFICIENCIES(X1) PROVIDER/SUPPLIER/LIGAND PLAN OF CORRECTIONIDENTIFICATION NUMBER:15C000108808/26/2013FORM
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What is this visit was for?
This visit was for a routine inspection by the health department.
Who is required to file this visit was for?
The manager of the establishment visited is required to file this visit.
How to fill out this visit was for?
The visit must be logged in the inspection report with details of the findings and any actions taken.
What is the purpose of this visit was for?
The purpose of the visit was to ensure compliance with health and safety regulations.
What information must be reported on this visit was for?
Information such as the date of the visit, name of the inspector, findings, and any corrective actions must be reported.
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