AGING AND DISABILITY SERVICES ADMINISTRATION

ADSA > Professionals & Providers > RCS > AFH

Information for Adult Family Home Providers

For questions or comments regarding the content on this page, contact the RCS Communications Manager.

• Admission Agreement Attestation Form (DSHS 10-270) (Word Format)
• Adult Family Home Locator
• AFH Administrator 48-hour Training
• AFH On-line Orientation Class Registration
• AFH Building Inspections
  • AFH Building Inspection Checklist
  • Find Your Local Building Official
• AFH Information
  • Information sheets
  • “What You Need To Understand” Before Becoming A Licensed Adult Family Home Provider (Word)
• AFH RULE Filings
  • CR 103 – Chapter 388-76
  • CR 103 – Chapter 388-76
  • CR 103 – Chapter 388-76
• Applications
• Background Check
  • Account Number
  • Background Authorization Form
  • Contact BCCU
  • Criminal History Regulations
  • Disqualifying Crimes List
  • DSHS Guidebook
• Caregiving Experience Attestation (CEA) Form for Resident Managers & Entity Representatives
• Citation Frequency & Related Data
• Communication Principles & Procedures for Inspection (Word Format)
• Communication Principles & Procedures for Complaint/Incident Investigation (Word Format)
• Contact RCS (Word Format)
• DSHS Forms
• Emergency Planning Information
• Enforcement Principles and Procedures
• FDA Recalls
  • Clarcon Skin Products
  • Information about FDA food, drug and other product recalls, market withdrawals and safety alerts http://www.fda.gov/opacom/7alerts.html
    
  • To receive e-mail updates of FDA recalls, market withdrawals and safety alerts, visit https://service.govdelivery.com/service/subscribe.html?code=USFDA_4
• Health-Care Decision Making
  • Advance Directives & Informed Consent Fact Sheet (Word)
  • Physician Orders for Life Sustaining Treatment (POLST) Fact Sheet (Word)
  • Your Legal Right to Make Decisions About Health Care & Advance Directives in Washington State (PDF)
  • POLST Form (PDF)
• Initiative 1029 Implementation
• Inspection Process (Word Format)
• Insurance Information Requests (Word Format)
• Mandated Reporters: Understanding Your Responsibilities
  • PDF Version
  • Word Version
• Monitoring Visit Principles & Procedures (Word Format)
• Poisonous Plant Resources (Word)
• Provider Letters
  • AFH 2009 "Dear Provider" Letters
  • AFH 2008 "Dear Provider" Letters
  • AFH 2007 "Dear Provider" Letters
  • AFH 2006 "Dear Provider" Letters
  • AFH 2005 "Dear Provider" Letters
  • AFH 2004 "Dear Provider" Letters
  • AFH 2003 "Dear Provider" Letters
  • AFH 2002 "Dear Provider" Letters
  • AFH 2001 "Dear Provider" Letters
• Q*SURE
• Revised Code of Washington (RCWs)
  • 43.190 - Long-Term Care Ombudsman Program
  • 69.41 - Legend Drugs - Prescription Drugs
  • 70.128 - Adult Family Homes
  • 70.129 - Long-Term Care Resident Rights
  • 74.34 - Abuse of Vulnerable Adults
• Sample AFH Evacuation Drill (Word Format)
• Sample AFH Negotiated Care Plan (Word Format)
• Specialized Dementia Care in AFHs Pilot Project
• State Hotline Questions - October 2003
• Telephone Script & Quick Tips for the Complaint Hotline (Word Format)
• Training Information for AFH
• Tuberculosis (TB) Resources
  • TB in WA State
  • TB Fact Sheet:  Foreign-Born Cases
  • CDC:  Guidelines for Using the QuantiFERON® TB Gold Test
• Washington Administrative Code (WAC)
  • 51-51-0325 - Building Code - Section R325
  • 388-105 - Medicaid Rates for Contracted Home & Community Residential Care Services
  • 388-76 - AFH Minimum Licensing Requirements
  • 246-840-910 to 960 - Nurse Delegation in Community-Based Settings
  • 246-888 - Medication Assistance
  • 365-18 - Long-Term Care Ombudsman Program
  • 388-112 - Residential Long-Term Care Services (Training WAC)