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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:15C000105307/17/2017FORM
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Start by gathering all the necessary information related to the visit, such as date, time, location, and purpose.
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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 establishment manager is required to file this visit.
How to fill out this visit was for?
The visit should be filled out using the online form provided by the regulatory agency.
What is the purpose of this visit was for?
The purpose of this visit is to ensure compliance with health and safety regulations.
What information must be reported on this visit was for?
The information that must be reported includes observations, corrective actions taken, and any violations found during the inspection.
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