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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:15G65812/12/2014FORM
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This visit was for a routine inspection of the facility.
The facility manager or owner is required to file this visit.
The visit should be filled out with the date, time, purpose, and any findings during the inspection.
The purpose of this visit was to ensure compliance with regulations and safety standards.
Information such as the condition of the facility, any violations found, and corrective actions taken must be reported.
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