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PRINTED: 10/15/2019 FORM APPROVEDState of GA, Healthcare Facility Regulation Division STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION(X1) PROVIDER/SUPPLIER/CIA IDENTIFICATION NUMBER:PCH007086(X2)
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Gather all necessary documents and forms required for filling out Destiny's personal care home application.
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Destiny's personal care home is a facility that provides care and support services to individuals who may need assistance with activities of daily living.
Owners or operators of personal care homes are required to file destinys personal care home.
Destinys personal care home can be filled out by providing information about the facility, services offered, number of residents, staff qualifications, and any incidents or complaints.
The purpose of destinys personal care home is to provide a safe and supportive environment for individuals who need assistance with activities of daily living.
Information that must be reported on destinys personal care home includes facility details, resident demographics, staff qualifications, services provided, incident reports, and complaints.
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2017 2019 lsc x1 eini12 x3 clia pch007086 x2 x4 deficiencies regulatory prefix continuation healthcare preceded cited ga deficiency provider summary identifying supplier violations

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