DSHS Form 06-169 Afh Change in Licensed Bed Capacity - Decrease - Washington

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DSHS Form 06-169 Afh Change in Licensed Bed Capacity - Decrease - Washington

What Is DSHS Form 06-169?

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 Form 06-169?
A: DSHS Form 06-169 is a form used for notifying the Department of Social and Health Services (DSHS) in Washington State about a decrease in licensed bed capacity in an Adult Family Home (AFH).

Q: What is an Adult Family Home (AFH)?
A: An Adult Family Home (AFH) is a residential home in Washington State that provides care and support services to aging or disabled adults.

Q: When should DSHS Form 06-169 be used?
A: DSHS Form 06-169 should be used when there is a decrease in the number of licensed beds in an Adult Family Home (AFH) in Washington State.

Q: Why is it important to notify DSHS about a decrease in licensed bed capacity?
A: It is important to notify DSHS about a decrease in licensed bed capacity because it ensures that the AFH is operating within the permitted limit and can continue to provide quality care to its residents.

Q: How can DSHS Form 06-169 be submitted?
A: DSHS Form 06-169 can be submitted electronically or by mail to the designated DSHS office.

Q: Are there any fees associated with submitting DSHS Form 06-169?
A: No, there are no fees associated with submitting DSHS Form 06-169.

Q: What information is required on DSHS Form 06-169?
A: DSHS Form 06-169 requires information such as the AFH provider's name, license number, current bed capacity, proposed bed capacity, and the effective date of the change.

Q: Are there any additional documents that need to be submitted with DSHS Form 06-169?
A: No, there are no additional documents that need to be submitted with DSHS Form 06-169, unless specifically requested by DSHS.

Q: What happens after submitting DSHS Form 06-169?
A: After submitting DSHS Form 06-169, DSHS will review the form and make a determination. The provider will be notified of the decision in writing.

Q: Is it possible to appeal DSHS's decision regarding a decrease in licensed bed capacity?
A: Yes, it is possible to appeal DSHS's decision regarding a decrease in licensed bed capacity. The provider will receive instructions on how to appeal if the request is denied.

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Form Details:

  • Released on August 1, 2016;
  • 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;

Download a printable version of DSHS Form 06-169 by clicking the link below or browse more documents and templates provided by the Washington State Department of Social and Health Services.

Download DSHS Form 06-169 Afh Change in Licensed Bed Capacity - Decrease - Washington

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