05-01 · Health Requirements Group: Sec. 7-4.05, Ordinance

Licensing monitor observed [1] personnel with a forged No.8 Physician's Statement of Good Health. Personnel has not been seen by a licensed physician or authorized agent. Licensing monitor observed [1] falsified No 8 Physician's Statement of Good Health. The form appeared to be a photocopy of a completed No.8 Form that had been written over. Licensing monitor compared documents and found a photo of the original No.8 in another personnel file. Licensing Monitor called the medical provider listed and their representative verified personnel in question was not seen by their physician

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.