| Statement of Deficiencies | (X1) Provider/Supplier/CLIA Identification Number 01G011 | (X3) Date Survey Completed 08/10/2022 |
| Name of Provider or Supplier Rainbow Omega, Inc, | Street Address, City, State 202 Hope Drive, Eastaboga, AL | |
| For information on the provider's plan to correct this deficiency, please contact the provider or the state survey agency. | ||
| (X4) ID Prefix Tag | Summary Statement of Deficiencies
(Each deficiency should be preceded by full regulatory or LSC identifying information) |
| W0000 | An unannounced on-site Recertification survey was conducted at the Davis/Orman Intermediate Care Facility from 8/8/22 to 8/10/22. There were no citations at the Condition Level. This facility is not in substantial compliance with 42 CFR 483, Subpart I, Requirements for Intermediate Care Facilities for Individuals with Intellectual Disabilities as evidenced by Standard level deficiencies being cited. |