PROGRAMS (Adult Facility)

The forms below are requirements by Community Care Licensing for an Adult Facility.  They are grouped based on Administration, Consumer, and Staff records needed to be sustained by a facility.

Administrative Records

Designation of Facility-Adult
Surety Bond-Adult
Disaster Report-Adult
Applicant Licensee-Adult
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Client Records

Client Cash Resources-Adult
Identification and Emergency -Adult
Physician Report-Adult
Preplacement Appraisal-Adult
Admission Agreement-Adult
Personal Rights-Adult
Personal Property-Adult
Centrally Stored Medication-Adult
Unusual Incident Injury-Adult
Death Report-Adult
Appraisal Needs and Service-Adult
Consent for Medical-Adult
Roster of Facility-Adult
Telecommunication Device-Adult
Functional Capability-Adult
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Records to be Maintained at the Facility

Records to be Maintained
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Personal Records

Personnel Report-Adult
Personnel Record-Adult
Health Screening Report-Adult
Criminal Record Statment-Adult
Criminal Record Exemption-Adult
Acknowledging Requirement-Adult
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