| Statement of Deficiencies | (X1) Provider/Supplier/CLIA Identification Number 013433 | (X3) Date Survey Completed 12/03/2025 |
| Name of Provider or Supplier Perfect Kids And Family Care | Street Address, City, State 308 Prairie Street North, Union Springs, 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) |
| E0000 | A recertification survey was conducted on 12/3/25 at Perfect Kids and Family Care Clinic. The clinic was found to be in substantial compliance with the Conditions for Certification for Emergency Preparedness. |
| J0000 | A recertification survey was conducted on 12/3/25 at Perfect Kids and Family Care Clinic. Standard level deficiencies were cited and will require a plan of correction. |
| J0125 | PROVISION OF SERVICES 491.9(b) Patient care policies. (3) The policies include: (iii) Rules for the storage, handling, and administration of drugs and biologicals. This STANDARD is not met as evidenced by: Based on observations and staff interview it was determined the clinic failed to ensure supplies available for patient use were not expired. This had the potential to negatively affect all patients served by the clinic. Findings include: 1. A tour of the clinic was conducted on 12/3/25 at 9:20 AM. The following supplies were expired and available for patient use. a. Two Swab Culturets with expiration date 4/30/24. b. One Primary Set Piggyback with Backcheck Valve with expiration date 6/1/25. c. Three Braun B Introcan Safety Intravenous Catheter 18 Gauge with expiration date 5/1/25. d. Two Mckesson True Metrix Control Solution Level 3 with expiration date 3/31/25. An interview was conducted on 12/3/25 at 9:38 AM with Employee Identifier # 1, Office Manager, who confirmed the clinic failed to ensure expired supplies were not available for patient use. |
| J0135 | PROVISION OF SERVICES 491.9(a) Basic requirements: (3) The laboratory requirements in paragraph (c)(2) of this section apply to RHCs, . . . 491.9(c) Direct services (2) Laboratory. These requirements apply to RHCs . . . . The RHC provides laboratory services in accordance with part 493 of this chapter, which implements the provisions of section 353 of the Public Health Service Act. The RHC provides basic laboratory services essential to the immediate diagnosis and treatment of the patient, including: (i) Chemical examinations of urine by stick or tablet method or both (including urine ketones); (ii) Hemoglobin or hematocrit; (iii) Blood glucose; (iv) Examination of stool specimens for occult blood; (v) Pregnancy tests; and (vi) Primary culturing for transmittal to a certified laboratory. This STANDARD is not met as evidenced by: Based on observations and staff interview, it was determined the clinic failed to ensure documentation of a current Clinical Laboratory Improvement Act (CLIA) certificate. This had the potential to negatively affect all patients served by the clinic. Findings Include: A tour of the clinic was conducted on 12/3/25 at 9:20 AM with Employee Identifier (EI) # 1, Office Manager. The surveyor observed the CLIA certificate with an expiration date of 8/31/25. An interview was conducted on 12/3/25 at 2:00 PM with EI # 2, Chief Executive Officer, who confirmed the clinic failed to ensure a current CLIA certificate. |