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This document outlines deficiencies observed during a State Residential Licensure Survey conducted at Cedarhurst of Edison Lakes, located at 1025 Park Place, Mishawaka, IN. The findings, which include failures in personnel training, sanitation, and food safety standards, detail specific areas that require corrective action and the facility\'s plans to address them.
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01
Gather all relevant documents and materials related to the situation being addressed.
02
Review the guidelines provided by the governing body regarding the statement of deficiencies.
03
Begin filling out the statement by clearly stating the specific deficiencies observed.
04
Provide detailed descriptions for each deficiency, including locations and dates if applicable.
05
Cite specific regulations or standards that were not met.
06
Include any supporting evidence such as photographs, witness statements, or inspection reports.
07
Complete the document with your contact information and the date of submission.

Who needs statement of deficiencies and?

01
Healthcare facilities undergoing inspections or evaluations.
02
Regulatory agencies that need to document compliance issues.
03
Legal entities involved in proceedings related to healthcare standards.
04
Accreditation organizations that assess facility performance.
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A statement of deficiencies is a formal document that outlines areas where an organization, particularly in healthcare or similar sectors, is not meeting established standards or regulations.
Organizations that are subject to regulatory oversight, such as healthcare facilities, are typically required to file a statement of deficiencies when they are found to be non-compliant during inspections.
To fill out a statement of deficiencies, organizations must accurately describe each area of non-compliance, provide evidence and documentation of the deficiencies, and outline corrective actions they plan to implement.
The purpose of a statement of deficiencies is to ensure accountability, improve compliance with regulations, and promote the quality of care and services provided by organizations.
Information that must be reported includes the nature of the deficiencies, specific regulations violated, dates of violations, and the organization's proposed corrective action plans.
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