Form Dshs 02 516 PDF Details

When individuals enter an Adult Family Home, it's crucial to ensure their personal belongings are meticulously accounted for, a task undertaken through the completion of the DSHS 02-516 form by the Aging and Long-Term Support Administration (ALTSA). This essential document, designed to be filled out upon a resident's admission, plays a pivotal role in safeguarding the personal items of those in care. It covers a wide range of belongings from essentials like contact lenses, dentures, and hearing aids, to personal items including jewelry and clothing. The form also extends to miscellaneous items such as mobility aids and electronics, ensuring a comprehensive inventory is taken. Both the provider or resident manager and the resident—or their guardian or agent—are required to sign this form, asserting the accuracy of the listed items. Moreover, this form underscores the commitment to privacy, stipulating that these records be managed in a way that maintains the confidentiality of the residents’ information. This process not only facilitates a smooth transition into the facility by reassuring residents and their families but also establishes a clear record that can be referenced if disputes about belongings arise. The DSHS 02-516 form is a testament to the conscientious care and detailed attention Adult Family Homes dedicate to those they serve, highlighting an important aspect of resident management and care coordination.

QuestionAnswer
Form NameForm Dshs 02 516
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other nameswashington dshs inventory, resident inventory form, resident inventory sheet, dshs home personal inventory

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So as to fill out this document, be sure you enter the necessary information in every blank field:

1. Start filling out your adult family home resident personal belongings with a selection of necessary blank fields. Get all of the required information and make sure there's nothing forgotten!

Part number 1 of submitting resident inventory sheet

2. Once your current task is complete, take the next step – fill out all of these fields - NUMBER, NUMBER, Bathrobe Belt Blouse Brassiere, MISCELLANEOUS, DESCRIPTION, ITEM, Brush Cane or crutches Clock, Statement I have read and agree, RESIDENTS OR GUARDIANS SIGNATURE, DATE, DATE, and DSHS REV with their corresponding information. Make sure to double check that everything has been entered correctly before continuing!

Completing part 2 of resident inventory sheet

Always be very attentive when filling out Statement I have read and agree and DATE, since this is where most people make a few mistakes.

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