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This version of the form is not currently in use and is provided for reference only. Download this version of
DSHS Form 10-410
for the current year.
DSHS Form 10-410 Adult Family Home License Application - Washington
What Is DSHS Form 10-410?
This is a legal form that was released by the Washington State Department of Social and Health Services - a government authority operating within Washington. Check the official instructions before completing and submitting the form.
FAQ
Q: What is DSHS Form 10-410?
A: DSHS Form 10-410 is the Adult Family Home License Application form in the state of Washington.
Q: What is an Adult Family Home?
A: An Adult Family Home is a residential home that provides care and services to up to six adults who are not related to the provider.
Q: Who needs to complete DSHS Form 10-410?
A: Any individual or entity wishing to open and operate an Adult Family Home in Washington must complete DSHS Form 10-410.
Q: What information is required on the application form?
A: The application form requires information about the applicant's personal background, the proposed home location, and the ability to meet licensing requirements.
Q: Are there any fees associated with the application?
A: Yes, there is a non-refundable application fee that must be submitted with the completed form.
Q: What happens after the application is submitted?
A: Once the application is submitted, it will be reviewed by DSHS for completeness and compliance with licensing requirements.
Q: How long does it take to get a license?
A: The licensing process can take up to 90 days from the date the application is received.
Q: What are the requirements to obtain an Adult Family Home license?
A: To obtain an Adult Family Home license, the applicant must meet certain criteria, including passing a background check, completing training, and meeting health and safety standards.
Form Details:
- Released on March 1, 2021;
- 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 10-410 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 10-410 Adult Family Home License Application - Washington
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