DSHS Form 15-458 Adult Family Home Notice of Transfer or Discharge - Washington

DSHS Form 15-458 Adult Family Home Notice of Transfer or Discharge - Washington

What Is DSHS Form 15-458?

This is a legal form that was released by the Washington State Department of Social and Health Services - a government authority operating within Washington. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is DSHS?A: DSHS stands for the Department of Social and Health Services, the agency in Washington state that provides assistance and support to individuals and families in need.

Q: What is Form 15-458?A: Form 15-458 is the Adult Family Home Notice of Transfer or Discharge, which is used in Washington state to notify and document the transfer or discharge of a resident from an adult family home.

Q: What is an Adult Family Home?A: An Adult Family Home is a residential facility in Washington state that provides housing and personal care services for elderly or disabled adults who are unable to live independently.

Q: When is Form 15-458 used?A: Form 15-458 is used when a resident of an adult family home in Washington state is being transferred to another facility or being discharged from the home.

Q: What information is required on Form 15-458?A: Form 15-458 requires the resident's personal information, reason for transfer or discharge, destination or receiving facility, and signatures of the resident, guardian, or legal representative.

Q: Who is responsible for completing Form 15-458?A: The adult family home staff or administrator is responsible for completing Form 15-458 and ensuring that all necessary information is provided.

Q: Can a resident refuse to sign Form 15-458?A: Yes, a resident has the right to refuse to sign Form 15-458, but their refusal does not exempt the adult family home from completing the form and providing the required notice of transfer or discharge.

Q: Is there a fee for submitting Form 15-458?A: No, there is no fee for submitting Form 15-458. It is a standard form used for documentation purposes in Washington state.

Q: What should I do if I have questions about Form 15-458?A: If you have questions about Form 15-458 or the transfer or discharge process for adult family homes in Washington state, you can contact the Department of Social and Health Services (DSHS) or your local adult family home regulatory office for assistance.

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Form Details:

  • Released on June 1, 2015;
  • The latest edition provided by the Washington State Department of Social and Health Services;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of DSHS Form 15-458 by clicking the link below{class="scroll_to"} or browse more documents and templates provided by the Washington State Department of Social and Health Services.

Download DSHS Form 15-458 Adult Family Home Notice of Transfer or Discharge - Washington

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