WebDIRECT CARE INDEPENDENT LIVING SKILLS ASSESSMENT Page 1 of 13 DSHS 10-592 (REV. 04/2024 ... subsequent assessors are to identify the assistance required, if the … WebForm 2382, Assisted Living Facilities Checklist Form 2383, Alzheimer's Certification Checklist Form 2384, Life Safety Code Checklist for Type A&B Facilities - 40 TAC §92.61 Form 2385, Life Safety Code Checklist for Small Type A Facilities - 40 TAC §92.61 Form 2386, Life Safety Code Checklist for Small Type B Facilities - 40 TAC §92.61
I hereby authorize release of medical information in this report to …
WebAssisted Living Facility Resident Characteristic Roster and Sample Selection Addendum - Attachment D : English (Word) English (Adobe PDF) 10-363 : Assisted Living Facility … WebIntake/Assessment Form SAMPLE SUPPORTIVE HOUSING INTAKE/ASSESSMENT FORM (This form must be completed within 30 days of program entry) IDENTIFYING INFORMATION Date Information is Gathered: _____ 1. Applicant Last Name: First Name: MI: 2. Address: _____ 3. station 19 recap 11/10/22
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WebRegulation 61-25, Retail Food Establishments (pdf) Criminal Record Checks of Direct Care Staff, Section 44-7-2910, et seq. Alzheimer's Special Care Disclosure Act, Section 44-36-510, et seq. Bill of Rights for Residents of Long Term Care Facilities, Section 44-81-10, et seq. Omnibus Adult Protection Act, Section 43-35-5, et seq. Forms WebThe Adult Family Care Home is a residential home designed to provide personal care services to individuals requiring assistance. The provider must live in the home and offers … Web12. Information about a resident's day-to-day assisted living service needs. § 2800.141(b)(1) - A resident shall have a medical evaluation: (1) At least annually. (2) If the medical … station 19 recap 11/3/22