Get Wa Dshs 10-508 2014

The WA DSHS 10-508 form serves as an essential resource for adult family home providers to disclose the services they offer, in compliance with Washington state regulations. This guide provides step-by-step instructions for filling out the form online, ensuring that users can navigate the process with confidence.

Follow the steps to complete the WA DSHS 10-508 online efficiently.

1. Press the ‘Get Form’ button to access the WA DSHS 10-508 form and open it for editing.
2. In the 'Home / Provider' section, enter the name of the adult family home and the license number as applicable.
3. Provide your optional provider’s statement to describe the home’s mission and values.
4. Fill in the initial licensing date, any other addresses where the provider has been licensed, and the previous address if applicable.
5. Indicate the ownership type, selecting from sole proprietor, limited liability corporation, co-owned, or other. If co-owned, provide the names of co-owners.
6. In the 'Personal Care' section, detail the personal care services provided, addressing each area such as eating, toileting, and others, as needed.
7. Provide information regarding medication services, outlining the type and amount of assistance offered for medication.
8. In the 'Skilled Nursing Services and Nurse Delegation' section, specify the skilled nursing services available and if nurse delegation is provided.
9. List any specialty care designations completed, such as for developmental disabilities or mental illness.
10. Describe the staffing arrangements, noting who lives in the home and the normal staffing levels for care.
11. Detail any cultural or language access services provided by the home.
12. Clarify the home’s policy on accepting Medicaid, stating the circumstances under which care is provided for Medicaid-eligible residents.
13. Outline activities available for residents, ensuring to include any custom arrangements.
14. Once all sections are completed, save your changes, and download, print, or share the completed form as needed.

Start filling out your documents online today to ensure compliance and clarity!