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Office of Health Care Assurance State Licensing SectionSTATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION Facilities Name: ErlindasCHAPTER 100.1Address: 2020 UHF Street, Honolulu, Hawaii 96819Inspection
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01
To fill out a statement of deficiencies, follow these steps:
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Begin by providing basic information, such as the name and address of the facility.
03
Identify the specific deficiency or deficiencies that need to be addressed.
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Provide a detailed description of each deficiency, including any supporting evidence or documentation.
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Clearly state the corrective action that will be taken to address each deficiency.
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Include a timeline for completing the corrective action.
07
If applicable, indicate any previous actions taken to address similar deficiencies.
08
Sign and date the statement of deficiencies.
09
Submit the completed statement of deficiencies to the appropriate regulatory authority.

Who needs statement of deficiencies and?

01
Statement of deficiencies is needed by various organizations and regulatory authorities to ensure compliance with established standards and regulations.
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These may include:
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- Nursing homes and long-term care facilities
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- Hospitals and healthcare organizations
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- Assisted living facilities
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- Home healthcare agencies
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- Rehabilitation centers
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- Behavioral health facilities
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- Hospice agencies
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- Residential care facilities
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- Any other organization or facility that provides care or services to individuals in a regulated environment.
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Statement of deficiencies is a report that details any violations or areas of non-compliance found during inspections or surveys of a facility.
Healthcare facilities and providers are required to file a statement of deficiencies when deficiencies are discovered during inspections or surveys.
Statement of deficiencies can be filled out by documenting the deficiencies found, proposed corrective actions, and a plan for addressing the deficiencies.
The purpose of statement of deficiencies is to ensure that healthcare facilities and providers address any violations or areas of non-compliance to ensure the safety and quality of care for patients.
Information reported on a statement of deficiencies includes details of the deficiency, proposed corrective actions, and timelines for correcting the deficiency.
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