You can search for reports, forms, policies and pamphlet and posters with information about specific programs and services.
Download | Number | Name | Effective Date |
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CCA-0005A | Log of Accidents, Injuries or Illnesses (English/Spanish) | 12/01/2022 |
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LCR-1000A | Agency Compliance Audit Checklist (English) | 12/01/2022 |
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LCR-1000C | Corrective Action Plan (Agency) (English) | 12/01/2022 |
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CCA-0036A | Permission to Give Medication | 12/01/2022 |
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LCR-1031B | Child or Adult Developmental Home Caregiver Assessment Guide (English) | 12/01/2022 |
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CAP-1001A | Community Action Service Providers | 12/01/2022 |
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DDD-0522A | DDD Intake Record (English) | 12/01/2022 |
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AAA-1346A-S | Verificación de Necesidad Médica | 12/01/2022 |
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DDD-1542A | Assisted Living Center Occupancy (English) | 12/01/2022 |
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CCA-0036A-S | Permiso para Administrar Medicamentos | 12/01/2022 |
Download | Number | Name | Effective Date |
---|---|---|---|
|
PPP-1063A | HIPAA Privacy Complaints (English) | 05/01/2018 |
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CCA-1141A | Direct Deposit Enrollment - DES Certified Homes/Relative Providers (English) | 05/01/2018 |
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RSA-1313A | Authorization for Release of RSA Records | 05/01/2018 |
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CCA-1141A-S | Direct Deposit Enrollment - DES Certified Homes/Relative Providers (Spanish) | 05/01/2018 |
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RSA-1313A-S | Autorización de Divulgación de Registros de RSA | 05/01/2018 |
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DDD-1404C | Employment Support Aide - Quality Assurance Review | 05/01/2018 |
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UB-296 | Report of Illness or Physical Disability (English) | 05/01/2018 |
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PAU-592 | Data Disclosure Information and Fee Schedule | 04/01/2018 |
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LCR-1080A | Licensing Investigation Template | 04/01/2018 |
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CSE-1171A | Affidavit of Financial Information (English/Spanish) | 04/01/2018 |
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