Forms for DDS

Adult Foster Home Forms

FAQ, Guides, and Tools for AFH
Psychotropics-Interpretive statement August 2023.pdf
AFH Licensing FAQ - Updated 8.15.23.docx

Correcting Documentation Errors
DHS/OHA Forms and Publications - If the form has a form # on the bottom right-hand corner, use this link to download.  

How to Access Other Forms
ISP Forms and protocols 
Tips for Training Hours

Individual Records
Activities Record (Sample)
Balancing Test for Psychotropic Medication (Sample)
Emergency Exit and Safety Orientation for Entry - UPDATED July 2023
Financial Record and Ledger (Sample)
Incident Report 
Individual Consent to HCBS Limitations
Mandatory Abuse Reporting for Adults
Medication Administration Record (Sample)
Notice of Involuntary Exit - 0719R (10/2019)
Personal Property Record (Sample)
Physician Visit and Order Form (Sample)
Progress Notes Template - Added July 2023
Resident Agreement Form - Updated April 2024 
Resident Bill of Rights (Must be posted)
Resident Record Table of Contents (Sample)
Safety Plan 

Variance Request Form and Instructions

Personnel, Training and Facility Records

Application for Employment (Sample)

Complaint Procedure (Must be posted)

Drug Disposal Record (Sample)

Emergency Phone Number List (Sample)

Emergency Plan Template (Fill-able)
Emergency Plan Annual Practice Record - Added July 2023
Emergency Supply List (FEMA Brochure)

Fire Evacuation, Smoke and Carbon Monoxide  Detector Checks (Sample)

Floor Plan Guidelines & Window Measurements

Hiring & Training Sub-Caregivers Checklist 

ISP and Support Documentation Training

Menu (Sample)

Personnel & Facility Records Checklist

Special & Modified Diets Training Record
Training Log 8.15.23.pdf - Updated August 2023
Substitute Caregiver Orientation Record (Sample)

2024 Wildfire Season Evacuation Information -

Click here for information about active evacuations.