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Deficiency Form (21) DPIR,DFC-1927 ALABAMA DEPARTMENT Of HUMAN RESOURCES OURCES #r CHILD CA-I� MINIMUM STANDARDS DEFICIENCY REPORT(Additlomral Page) L FAt'l��ly Name: �i Date of sit., 1' - - �•r SEC 'I+DP+I B=DCF'ICIEi�iC9l1I;ORP✓IAT><ON Corttfnucd Waimu ,5p_ andnrd' i3afc Corrcctr_ci'by Deticiency Licensee CDru - j r AmdYideid Q r / SZ .2-6 � aa L cry 1' ,A A les 43de ;f rt;a a1 I i. 3 INSTRUCTIONS TO LICENSEE: QL/guui;,Date CZMeedrd'1 g grenL,ce. It iti lie camPleiet!'by dru juclllla!represenla/lve rfJTer ancli de Iekncy is corrected, T/1e frrclllra.reP-M 0]r010e must part the dal, of.cnrr Ilo� ntiit! srher fttlllnls!rt Coltntnr?. Tltls jnrrtr tlrrtst!ie returned to the Depnrintew of Hjunan Resources on or bcjorc '7 corrected. rrs verlJlcaliun that dcflctenelar!tear been 'r Vuzurd/ inust he'coriccterllttltttedlatel�► NOTICE; Any misleading or any false statements or reports made to the Dcpartmcut and/or fhRurc to correct file listed dcftlencles can bc'the hasis for adverse nttfitin, None of thavr requirements are to be Interpretc&to 11110w anyone to opernfe in viulntfon of Ini- 'o Standards, A facility licensed by the Department must meet MitilEllgtn tandnrds applicable to that facility, nt ail times, It is [Ile responsibilityof tb a ltssnacc'fo oprrafe in comtdiancc.�yitit!ti]lnirn�em 5tnn�lardt. - 'i 51�rurure of ncilliy/leprrsc,nlaliIle -®r, \- Dulu, Ir^ ;S%gnuitn a ujL7NR Licvrrdng llepresrnturftv re� ��� tt COPIE$TO, Yagc -,_.�,of itl tj i 15 i• _