Forms
Client Files
Facility Files
Staff Files
Client Files
- Client_s File Tab 1.pdf
- Client_s File Tab 2.pdf
- Client_s File Tab 3.pdf
- Client_s File Tab 4.pdf
- Client_s File Tab 5.pdf
- DSP 304 – Rightsof Individual.pdf
- LIC 601 – Identification and Emergency Information.pdf
- LIC 602 – Physician_s Report.pdf
- LIC 604-Admission Agreement.pdf
- LIC 613C – Personal Rights.pdf
- LIC 621-Client Personal Property and Valuables.pdf
- LIC 622- Centrally Stored Medication.pdf
- LIC 625-Appraisal Needs and Services Plan.pdf
- LIC405 – P _ I.pdf
- LIC603 – Preplacement Appraisal Information.pdf
- LIC603A – Resident Appraisal.pdf
- LIC605A – Release Of Client_Resident Medical Information.pdf
- LIC624 – Unusual Incident_Injury Report.pdf
- LIC627C – Consent for Emergency Medical Treatment.pdf
- LIC9060 – Theft and Loss Record.pdf
- LIC9158 – Telecommunications Device Notification.pdf
- LIC9172 – Functional Capability Assessment.pdf
- PRN Authorization Letter.pdf
- Special Incident Report Form.pdf
- Weight Record.pdf
Facility Files
- Facility File Tab 2.pdf
- Facility Tab 1.pdf
- Fire and Earthquake Drill.pdf
- LIC 610E – Emergency Disaster Plan For Residential Care Facilities For The Elderly.pdf
- LIC308 – Designation Of Facility Responsibility.pdf
- LIC400 – Affidavit Regarding Client_Resident Cash Resources.pdf
- LIC610D-Emergency Disaster Plan for ARF.pdf
- LIC809 – Facility Evaluation Report.pdf
- LIC9020 – Register Of Facility Clients_Residents.pdf
- Smoke Alarms and Carbon Monoxide Routine Inspection.pdf
Staff Files