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2567 i X6 DATE TITLE I. -. / 1 1 of 10 CAlIFORNIA HEAlTH AND HUMAN SERVICES AGENCY X1 PRO In ERiSUPPUEAlCUA Xl MULTIPLE cONSTRUCTION IOENTlACAnON NUMBER A. BUILDING NAME OF PR01J1DER OR SUPPUER B MNG X4 ID IX /0 Continued From page 1 a. How the correction will be accomplished both temporarily and permanently. The CDPH verified that the facility informed the patient or the party responsible for the patient of the adverse event by the time the repo.

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