Discharging or transferring a resident from your adult family home is never an easy decision. Ensure that you are following WAC 388-76-10615 and WAC 388-76-10616 prior to pursuing a transfer and discharge of a resident.
Transfer and Discharge Notice Transfer and Discharge Notice
- Activities
- Behavioral Health Information
- Logs and Forms
- Evacuation Form
- Adult Family Home Injuries and Accidents Log
- AFH Incident Investigation Form
- Behavior Log
- Blood Glucose Log
- Resident Crisis Plan Template
- Resident Refusal Form
- Adult Family Home Resident Personal Belongings Inventory (Residential Care Services)
- Adult Family Home (AFH) Resident Significant Change Assessment Request
- Social Leave Tracking Form
- Sample Letters
- Adult Family Home Rate Increase Sample Letter
- Relocation Letter to Resident and Resident Representatives
- TB Testing (required within 3 days of licensure)
- Liability Insurance
- Information for Adult Family Home Providers-ALTSA
- Labor & Industries
- Find Your Local DSHS Office
- Applying for a Medicaid Contract
- Subscribe to receive updates from DSHS-Govdelivery
- RCS Standard Operating Procedures Manual
- Medical Test Site Waiver
- Washington State Medical Test Site Certificate of Waiver Requirements
- Waived Medical Test Site License Application Helpful Tips & Instructions
- Medical Test Site Waiver PowerPoint
- Information for Adult Family Home Owners
- Dear Provider Letters
- Aging and Long-Term Support Administration Long-Term Care Manual
- Home and Community Services Management Bulletins
- Residential Care Services Management Bulletins
Caring for residents in an Adult Family Home in Washington State involves a commitment to providing a safe, nurturing environment tailored to the unique needs of each individual. Adult Family Homes offer personalized support for adults who may require assistance with daily living activities, fostering a sense of community and belonging. The admission process is designed to ensure that potential residents receive the appropriate care and support, taking into account their specific health and personal needs. By prioritizing compassion and individualized attention, Adult Family Homes strive to enhance the quality of life for their residents while maintaining compliance with state regulations.
- State licensing Initial Inspection Preparation Checklist – Initial Checklist
- Initial Licensing Inspection Working Papers
- CHAPTER 11: Residential Inspection and Quality Assurance Program (RIQAP) ALTSA Residential Care Services, Standard Operating Procedures Manual
- State licensing Initial Inspection Preparation Checklist –State licensing Initial Inspection Preparation Checklist
- Postings:
- Complaint Resolution Unit/Hotline/Ombudsman Poster
- Disability Rights Washington Poster
- AFH Information Sheet
- Region 1 Residential Care Services Office Contact Information
- Region 2 Residential Care Services Office Contact Information
- Region 3 Residential Care Services Office Contact Information
- DSHS & RCS Region Map
- Sample Resident Records Review
- Adult Family Home Resident Personal Belongings Inventory (Residential Care Services)
- Resident Information Sheet (Face Sheet)
- Sample Preliminary Service Plan Template
- Disclosure of Charges Form-DSHS
- Advance Directives Policy
- Portable Orders for Life-Sustaining Treatment (POLST)
- Management of Resident’s Funds
- Administrative Records
- Facility Orientation Checklist
- Succession Plan Template
- Employee Checklists
- Logs
- Housekeeping & Maintenance Information
- House Cleaning Tasks
- House Maintenance List
- Revised Codes of Washington (RCW) & Washington Administrative Codes (WAC)
- WAC 388-112A
- WAC 388-76
- WAC 246-840
- WAC 388-113
- RCW 70.128
- RCW 70.129
- RCW 74.34
- Postings:
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- Business Applications & Analysis Unit (BAAU)
- Adult Family Home Application Link (Secure Access Washington)
- Adult Family Home License Web Application Instructions
- AFH Online Application Checklist
- Sample Policies
- Sample Admission Agreements (Notice of Rights and Services Requirements)
- Disclosure of Services Form DSHS 10-508
- Background Check Authorization Forms for any person listed on the application or over the age of 11 and living in the home at time of application
- Training Requirements for Entity Representative or Sole Proprietor and Resident Manager
- AFH Orientation (must be repeated if not completed within one year of licensure)-not required for Resident Manager
- AFH Administrator Training Certificate-not required for Resident Manager
- Proof of Education
- Home Care Aide, NA-C or Proof of Exemption
- First Aid/CPR Training Certificate
- Food Safety-Do it Right, Serve it Safe! (wa.gov)
- 1000 Hours Caregiving Experience Attestation
- Sample Property Owner Statement
- Local Building Inspection (not needed for a CHOW)
- Parking Plan Multiple Homes
- Add these forms if you are doing a CHOW
A floor plan for each level of the home will also need to be submitted with the building inspection checklist and the AFH Application.
If your home is on a septic system, the system will need to be inspected by your local health authority or approved septic system inspection entity and you will need to provide documentation of the following:
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- The septic system has been inspected and approved
- How many people (not bedrooms) the system can accommodate
- The local health authority or inspection entity is aware that the system will be used in an AFH
This information does not need to be submitted with the application but it will need to be provided to the licensor prior to licensure recommendation. There can be significant costs associated with septic system improvements, so it is highly recommended this process be completed prior to submitting the application.
All Adult Family Homes in Washington State are licensed and regulated to ensure compliance with established standards. Prospective providers must fulfill various educational and training requirements before they can obtain licensure. Once licensed, these homes are subject to regular inspections by multiple regulatory bodies, including the Department of Health and Social Services (DSHS), the Department of Health (DOH), and Washington State Labor & Industries (L&I), as well as federal oversight.
One significant advantage of membership with the Adult Family Home Council is the opportunity for members to have their applications reviewed prior to submission to the Department. This pre-submission review helps ensure that applications are complete and increases the likelihood of efficient processing once submitted.
How Long Does It Take To Become Licensed?
- Processing of an application for licensure does not begin until the application is considered complete (i.e. all requested items received by the Business Analysis & Applications Unit);
- Once the application is determined to be complete, the processing timeline begins and could take up to 60 days.
- On-site inspection by the Department must occur as part of the licensing process and licensure depends on the results of this inspection.
- The majority of applicants do not meet minimum licensing requirements on the first inspection, thus requiring a subsequent visit.
- After each inspection, the Department sends a letter to the applicant clearly outlining which licensing requirements have not been met and the specific issues that led to them not being met.
- The Department has a maximum of 3 inspection visits; if after the third visit the applicant has still not met all the licensing requirements, the case is reviewed to determine the extent of the non-compliance and if a fourth visit is warranted.