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 WebDSHs Rcs Region 3 Completion Date January 29, 2024 Statement of Deficiencies Plan of CotTection Page I of 8 PO Box 98907, Lakewood, WA 98496 ... Review of the ALF Characteristic Roster dated 01/22/20, showed Resident #5 was admitted to r—18. Resident #5 was observed in his apartment on 01/22/20 at I I AM.
Assisted Living Facility Request For Documentation
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 ... WebRecord Reviews: Resident characteristic roster, staff list, infection line list, resident records, infection control policies and procedures, staff training, Page 1 of2 Thisdocument w / Residential Care Services Investigation Summary Report Allegation Summary: cleveland oh for rent
Assisted Living Facility Resident Group Meeting
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. WebAcronym. Definition. DHSH. Department of Social and Health Services. DHSH. Drilled Hex Socket Head Cap. 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: bme hotcopper