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Application for License to Operate an Assisted Living Home: Household Member Worksheet - Alaska
Application for License to Operate an Household Member Worksheet is a legal document that was released by the Alaska Department of Health and Social Services - a government authority operating within Alaska.
FAQ
Q: What is the purpose of the Household Member Worksheet?
A: The Household Member Worksheet is used to gather information about the individuals residing in the assisted living home.
Q: Who needs to fill out the Household Member Worksheet?
A: The licensee or applicant for a license needs to complete the Household Member Worksheet.
Q: What information is required on the Household Member Worksheet?
A: The Household Member Worksheet requires information such as name, age, relationship to the licensee, and criminal history.
Q: Why is criminal history information required?
A: Criminal history information is required to ensure the safety and well-being of residents in the assisted living home.
Form Details:
- Released on September 9, 2019;
- The latest edition currently provided by the Alaska Department of Health and Social Services;
- Ready to use and print;
- Easy to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a fillable version of the form by clicking the link below or browse more documents and templates provided by the Alaska Department of Health and Social Services.
