AHCA Form 3110 1023 (AFCH-1110) is required by Florida's Agency for Health Care Administration for evaluating prospective residents of Adult Family-Care Homes. A licensed health professional completes this assessment to verify the AFCH can meet the resident's care needs before placement.
The form covers six key areas:
Related AHCA assessments: AHCA Form 1823 (ALF Resident Health Assessment), AHCA Form 3100-0008, and the Resident Assessment Form. For additional Florida care facility documents, see the Florida Health Care Surrogate Form.
| Question | Answer |
|---|---|
| Form Name | AHCA Form 3110 1023 |
| Form Type | Resident Health Assessment |
| State | Florida |
| Issued By | Florida Agency for Health Care Administration (AHCA) |
| Form Length | 3 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 45 sec |
| Other names | AFCH-1110, ahca assessment, form 3110 1023, resident health assessment adult family care |