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Dshs 10 2018

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Application. Section 1. Type of Application Initial application fee 2750 Change of Ownership application fee 700 Relocation application fee 2750 Current AFH address Current AFH license number Section 2. Information about Proposed Adult Family Home 1. NAME OF PROPOSED ADULT FAMILY HOME 2. STREET ADDRESS CITY STATE 3. MAILING ADDRESS IF DIFFERENT FROM ABOVE ZIP CODE 4. FACILITY TELEPHONE NUMBER 5. CONFIDENTIAL FAX NUMBER 6. CELL PHONE NUMBER 7. EMAIL ADDRESS REQUIRED COUNTY Section 3. Landlord...

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What is the DSHS 10 237?

The DSHS 10 237 form, also known as the Adult Family Home License Application, is a crucial document for individuals seeking to operate an adult family home in Washington State. This form is essential for ensuring compliance with state regulations governing the care of vulnerable populations, including the elderly and individuals with disabilities. The application collects necessary information about the applicant, the proposed facility, and the services to be provided.

Steps to Complete the DSHS 10 237

Filling out the DSHS 10 237 requires careful attention to detail. Here are the key steps to ensure accurate completion:

  • Gather personal and facility information, including addresses, contact details, and ownership structure.
  • Detail the services you plan to offer, including the types of care and support available to residents.
  • Provide information about staff qualifications and training to demonstrate compliance with state requirements.
  • Review the application for completeness and accuracy before submission.

Legal Use of the DSHS 10 237

The DSHS 10 237 form must be completed in accordance with Washington State laws and regulations. It serves as a legal document that, once approved, grants the applicant the authority to operate an adult family home. Compliance with all relevant laws ensures that the facility meets health and safety standards, protecting both residents and staff.

Required Documents for the DSHS 10 237

When submitting the DSHS 10 237, applicants must include several supporting documents. These typically include:

  • Proof of ownership or lease agreement for the facility.
  • Background check documentation for all staff members.
  • Training certificates for caregivers and staff.
  • Emergency preparedness plans and policies.

How to Obtain the DSHS 10 237

The DSHS 10 237 form can be obtained through the Washington State Department of Social and Health Services (DSHS) website or by contacting the local DSHS office. It is important to ensure you are using the most current version of the form to avoid any delays in the application process.

Form Submission Methods

Applicants can submit the completed DSHS 10 237 form through various methods, including:

  • Online submission via the DSHS portal, if available.
  • Mailing the form to the appropriate DSHS office.
  • In-person submission at a local DSHS office for immediate processing.

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WA DSHS 10-410 20204.8 Satisfied (2002 Votes)
WA DSHS 10-410 20184.8 Satisfied (4948 Votes)
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