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PRINTED: 04/15/2019 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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Obtain the necessary application form from the Pitt County Group Home office.
02
Fill out the application form completely and accurately, providing all required information.
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Submit the completed application form to the Pitt County Group Home office either in person or by mail.
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Pitt County group home is a residential facility that provides housing and support services for individuals who require assistance with daily living activities.
The owner or operator of the Pitt County group home is required to file the necessary paperwork and reports.
To fill out the paperwork for Pitt County group home, the owner or operator must provide information about the facility, its residents, staff, services provided, and any other required details.
The purpose of Pitt County group home is to provide a safe and supportive living environment for individuals who need assistance with daily living activities.
Information to be reported on Pitt County group home may include number of residents, staff-to-resident ratio, services offered, any incidents or emergencies, and any other relevant details.
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