| Statement of Deficiencies | (X1) Provider/Supplier/CLIA Identification Number 883825 | (X3) Date Survey Completed 02/23/2026 |
| Name of Provider or Supplier Healthy Kids Llc | Street Address, City, State 220 West Cedar Street, Shelbyville, TN | |
| 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) |
| J0000 | A unannounced recertification survey was initated at the facility on 02/23/2026 at 10:25 AM. An entrance conference was held with the Medical Assistant on 02/23/2026 at 10:30 AM. The purpose of the survey was explained and requests made. An opportunity for questions/concerns was provided. An Exit Conference was held at the facility with the Office Manager on 02/23/2026 at 3:30 PM. The Office Manager was notified of the preliminary survey findings of no deficiences cited under Fed-J-10.01. |