
Get the free printed: 03/29/2019 - form approved omb no. 0938-0391
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PRINTED: 08/02/2016
FORM APPROVEDDivision of Health Service Regulation
STATEMENT OF DEFICIENCIES
AND PLAN OF CORRECTION(X1) PROVIDER/SUPPLIER/CIA
IDENTIFICATION NUMBER:ROYAL OAKS ASSISTED LIVING
(X4)
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