DSHS Form 13-645 Adult Family Home Injuries and Accidents Log - Washington

DSHS Form 13-645 Adult Family Home Injuries and Accidents Log - Washington

What Is DSHS Form 13-645?

This is a legal form that was released by the Washington State Department of Social and Health Services - a government authority operating within Washington. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is DSHS Form 13-645?
A: DSHS Form 13-645 is a log used to document injuries and accidents that occur in adult family homes.

Q: What is an adult family home?
A: An adult family home is a residential facility that provides care to a small number of elderly or disabled adults.

Q: Why is it important to log injuries and accidents in adult family homes?
A: Logging injuries and accidents is important for tracking incidents, identifying trends, and ensuring the safety and well-being of residents.

Q: Who uses DSHS Form 13-645?
A: Adult family home staff and administrators use DSHS Form 13-645 to document injuries and accidents.

Q: Do I need to submit DSHS Form 13-645 to the DSHS office?
A: Yes, completed DSHS Form 13-645 logs need to be submitted to the DSHS office as part of the regular reporting requirements for adult family homes.

Q: Are adult family homes regulated in Washington?
A: Yes, adult family homes in Washington are regulated by the Washington State Department of Social and Health Services.

Q: What types of injuries and accidents should be recorded in the log?
A: All significant injuries and accidents, including falls, medication errors, and other incidents, should be recorded in the log.

Q: Can family members access the log?
A: Family members of residents in adult family homes can request access to the log, as it contains important information about the care and safety of their loved ones.

Q: How long should the log entries be kept?
A: Log entries should be kept for a minimum of three years and can be longer if required by the adult family home's policies or regulations.

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Form Details:

  • Released on February 1, 2014;
  • The latest edition provided by the Washington State Department of Social and Health Services;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of DSHS Form 13-645 by clicking the link below or browse more documents and templates provided by the Washington State Department of Social and Health Services.

Download DSHS Form 13-645 Adult Family Home Injuries and Accidents Log - Washington

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