PDF
Word
DSHS Form 10-389A Additional Room List for Assisted Living Facilities (Alf) - Washington
What Is DSHS Form 10-389A?
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 10-389A?
A: DSHS Form 10-389A is the Additional Room List for Assisted Living Facilities (ALF) in Washington.
Q: What is the purpose of DSHS Form 10-389A?
A: The purpose of DSHS Form 10-389A is to provide a list of additional rooms in an Assisted Living Facility.
Q: Who is required to fill out DSHS Form 10-389A?
A: Assisted Living Facilities in Washington are required to fill out DSHS Form 10-389A.
Q: Is there a fee for submitting DSHS Form 10-389A?
A: No, there is no fee for submitting DSHS Form 10-389A.
Q: What information is required on DSHS Form 10-389A?
A: DSHS Form 10-389A requires information about the additional rooms in the Assisted Living Facility, including room number, description, and occupancy details.
Q: When should DSHS Form 10-389A be submitted?
A: DSHS Form 10-389A should be submitted whenever there are changes or additions to the rooms in the Assisted Living Facility.
Form Details:
- Released on March 1, 2017;
- 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 10-389A by clicking the link below or browse more documents and templates provided by the Washington State Department of Social and Health Services.
