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PRINTED: 09/27/2022 FORM APPROVEDDivision of Health Service Regulation STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION(X1) PROVIDER/SUPPLIER/CIA IDENTIFICATION NUMBER:(X2) MULTIPLE CONSTRUCTION A.
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Substantiated intake nc00192601 refers to a report submitted to provide details of confirmed or verified incidents or cases.
Organizations or individuals designated as responsible for reporting and documenting verified incidents are required to file substantiated intake nc00192601.
Substantiated intake nc00192601 should be completed by providing accurate details of the verified incidents or cases, along with relevant supporting documentation.
The purpose of substantiated intake nc00192601 is to track and record confirmed or verified incidents for regulatory compliance and analysis.
On substantiated intake nc00192601, information such as incident details, date of occurrence, parties involved, and actions taken must be reported.
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