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PRINTED: 06/10/2024 FORM APPROVEDDivision of Health Service Regulation STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION(X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER:ROLLING RIDGE ASSISTED LIVING

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How to fill out nc dhsr acls statement

01

Obtain the NC DHHS ACLS statement form from your local health department or the official website.

02

Fill in your personal information, including name, address, and contact information.

03

Provide details about your current medical credentials and certifications related to Advanced Cardiac Life Support.

04

Indicate the purpose for obtaining the ACLS statement and any relevant employment or educational context.

05

Review the completed form for accuracy and completeness.

06

Sign and date the form where indicated.

07

Submit the form according to the provided instructions, either by mail or electronically.

Who needs nc dhsr acls statement?

01

Healthcare professionals seeking certification in Advanced Cardiac Life Support.

02

Individuals applying for jobs that require ACLS certification.

03

Students in health-related fields needing ACLS certification for clinical practice.

04

Existing medical personnel needing to renew or update their ACLS statement.

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What is nc dhsr acls statement?

The NC DHHS (North Carolina Department of Health and Human Services) ACLS (Assistant Certified Lifeguard Statement) is a required report that provides information regarding the qualifications and certifications of personnel working in areas related to health and safety.

Who is required to file nc dhsr acls statement?

Individuals or organizations that operate health facilities or provide health-related services in North Carolina are required to file the NC DHHS ACLS statement.

How to fill out nc dhsr acls statement?

To fill out the NC DHHS ACLS statement, gather all necessary information regarding personnel qualifications, follow the provided guidelines for completion, and submit the form online or as directed by the DHHS.

What is the purpose of nc dhsr acls statement?

The purpose of the NC DHHS ACLS statement is to ensure that health facilities and services maintain qualified personnel to deliver safe and effective healthcare.

What information must be reported on nc dhsr acls statement?

The NC DHHS ACLS statement must include personnel qualifications, certification statuses, and other relevant information reflecting compliance with state regulations.

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