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Characteristic roster dshs

WebCompleted Resident Characteristic Roster/Sample Selection (Attachment D). Completed list of staff with names, position, hire date, and month/day of birth (Attachment K). Request a copy of evidence of liability insurance coverage from the licensee/administrator. Request a copy of the disclosure form to identify the scope of care and services. WebDSHS 10-362 (10/2004) BOARDING HOME RESIDENT CHARACTERISTIC ROSTER ATTACHMENT D TOTAL CENSUS: BOARDING HOME NAME: LICENSE NUMBER: …

This do cument - Washington

WebPre-Inspection Preparation – Attachment A (DSHS 15-571) Request for Documentation – Attachment B (DSHS 15-572) Resident List – Attachment C (DSHS 15-573) … Webcharacteristic roster, staff list, chart notes, medication administration records, Allegation Summary: 1) COVID positive test for a staff member. Record review showed the facility was screening staff upon start of shift. Observations showed the facility beauty salon was in operation during outbreak and staff were not wearing appropriate eye ... cuffed love your melon beanies https://bohemebotanicals.com

Assisted Living Facility Request For Documentation - Attachment B

WebComplete Assisted Living Facility Resident Characteristic Roster And Sample Selection - Attachment D - Dshs online with US Legal Forms. Easily fill out PDF blank, edit, and … WebRecord Reviews: Characteristic Roster, Infection Control Policy, COVID-19 protocols, screening, testing, reporting suspected and actual cases of a communicable illness. Page 1 of2 This do cument ... (COVID19) to DSHS as required, and did not take the necessary preventative and protective actions to manage and limit the spread within the facility. WebAttachment D (Resident Characteristic Roster/Sample Selection) (DSHS 10-362) Attachment N (Contract Requirements) (DSHS 10-372) Attachment O (Environmental Observations for Contract Requirements) (DSHS 10-373) Attachment P (Food Service Observations) (DSHS 10-486) PROCEDURES. The Licensor will: cuffed nasopharyngeal airway

Assisted Living Facility Resident Characteristic Roster and …

Category:Electronic DSHS Forms DSHS - Washington

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Characteristic roster dshs

Assisted Living Facility Resident Characteristic Roster And …

WebRecord Reviews: Resident characteristic roster, staff roster, staff work schedules, resident records (assessments, care plans, temporary service plans (TSP's) and progress notes), incident investigations, facility policy and procedures, facility's COVID-19 preparedness and response plan and the staff/visitor screening logs. Allegation Summary: 1. WebA completed resident characteristic list (Attachment D, DSHS 15-574). Include all licensed rooms and all residents Complete list of staff, position title, birthdate, shift, and hire date Working schedule of care staff, nursing staff. MHPs and on-call RN and MHPs for prior two weeks Disclosure of Admission Agreement Location of the resident records

Characteristic roster dshs

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WebAssisted Living Survey/Certification Forms UPDATED and CURRENTLY BEING USED 1. Attachment A (Pre-Inspection Preparation) (DSHS 10-359) 2. Attachment B (Request For Documentation) (DSHS 10-360) 3. Attachment C (Resident List) (DSHS 10-361) 4. Attachment D (Resident Characteristic Roster/Sample Selection) (DSHS 10-362) 5. …

WebAttachment D (Resident Characteristic Roster/Sample Selection) (DSHS 10-362) Attachment E (Resident Group Meeting) (DSHS 10-363) PROCEDURES. The Licensors … WebCharacteristic Roster Page 1 of2 This do cument w / Residential Care Services Investigation Summary Report Allegation Summary: 1. The facility implemented additional infection control policy and procedures following COVID19, to ensure safety and well-being for the residents of the Named Facility.

WebOct 1, 2024 · Download Printable Dshs Form 10-369 Attachment K In Pdf - The Latest Version Applicable For 2024. Fill Out The Assisted Living Facility Resident Characteristic Roster And Sample Selection - Washington Online And Print It Out For Free. Dshs Form 10-369 Attachment K Is Often Used In Washington State Department Of Social And … WebDSHS 10-362A (02/2024)Page 1 of 3 CONFIDENTIAL INFORMATION – DO NOT DISCLOSE NOT FOR PUBLIC DISCLOSURE ALF Resident Characteristic Roster and Sample Selection Addendum Attachment D

WebAttachment D (Resident Characteristic Roster/Sample Selection) (DSHS 10-362) Attachment I (Environmental Observations) (DSHS 10-367) Attachment K (Facility Staff Sample/ Record Review) (DSHS 10-369) Attachment L (Notes/Worksheet) (DSHS 10-370) Attachment N (Contract Requirements)

http://www.whca.org/wp-content/themes/whca/weeklyupdate/alforms.pdf cuffed mugshotsWebDSHS 10-362A (02/2024) Page 1 of 2. CONFIDENTIAL INFORMATION – DO NOT DISCLOSE NOT FOR PUBLIC DISCLOSURE . ALF Resident Characteristic Roster and Sample Selection Addendum Attachment D . ALF NAME . LICENSE NUMBER INSPECTION DATE RESIDENT ROOM ADMIT DATE RESIDENT ID NUMBER … eastern cape hustlers awardsWeb(Attachment C-only required if no Resident Characteristic Roster provided) Within two (2) hours of entry of facility * Note: Maintaining a Resident Characteristic Roster, DSHS 10-362 form, could expedite the amount of time licensors have to be onsite for an inspection. eastern cape hospitals and contact detailsWebAssistant Director of Dietetics. Assistant Hospital Administrator. Assistant Seamer. Associate Accounting Analyst. Associate Administrative Analyst (Accounting Systems) … cuffed newborn sleeperWebResident assessed as meeting the definition of medically fragile per WAC: A chronic and complex physical condition which results in prolonged dependency on specialized … cuffed newspaperWebDSHS RCS REGION 3 Completion Date December I l, 2024 Statement of Deficiencies Plan of Correction Page I of 5 PO Box 98907, Lakewood, WA 98496 ... Review of the Resident Characteristic Roster dated 12/04/19 showed Resident #1 was admitted —17. Review of the care plan dated 08/20/19 showed Resident #1 was to the ALF on iagnosis. eastern cape jobs 2022WebAssisted Living Survey/Certification Forms UPDATED and CURRENTLY BEING USED 1. Attachment A (Pre-Inspection Preparation) (DSHS 10-359) 2. Attachment B (Request … eastern cape hunting safaris