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- Licensing Specialist: Chelsea Vardell.
- Specialist conducted facility visit from 1220 – 1515. Facility CEO reported that repairs to the facility are proceeding, and the floors are being resurfaced today. Specialist completed record review for 5 clients.
- Regs out of compliance –
- R902.13 – Three clients missing immunization record, birth certificate & social security card. Two clients missing birth certificate & immunization record. Due date: 4/29/22.
- TA –
- R902.10 – Specialist provided education to staff on what information is required at the time of admission.
- R902.12 – Specialist provided education to staff on what intake information should be gathered within ten days of admission.
- Regs not correctable –
- R903.4 – Client did not have a Master Treatment Plan in her chart. Client has been admitted for more than 30 days.
- R905.17 – Restraint justification packet for client that was conducted on 11/20/21 would not be located.