Department of Health & Human Services

Centers for Medicare & Medicaid Services
Form Approved

OMB No. 0938-0391

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.