DSHS Form 10-389A Additional Room List for Assisted Living Facilities (Alf) - Washington

DSHS Form 10-389A Additional Room List for Assisted Living Facilities (Alf) - Washington

What Is DSHS Form 10-389A?

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 10-389A?A: DSHS Form 10-389A is the Additional Room List for Assisted Living Facilities (ALF) in Washington.

Q: What is the purpose of DSHS Form 10-389A?A: The purpose of DSHS Form 10-389A is to provide a list of additional rooms in an Assisted Living Facility.

Q: Who is required to fill out DSHS Form 10-389A?A: Assisted Living Facilities in Washington are required to fill out DSHS Form 10-389A.

Q: Is there a fee for submitting DSHS Form 10-389A?A: No, there is no fee for submitting DSHS Form 10-389A.

Q: What information is required on DSHS Form 10-389A?A: DSHS Form 10-389A requires information about the additional rooms in the Assisted Living Facility, including room number, description, and occupancy details.

Q: When should DSHS Form 10-389A be submitted?A: DSHS Form 10-389A should be submitted whenever there are changes or additions to the rooms in the Assisted Living Facility.

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Form Details:

  • Released on March 1, 2017;
  • 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 10-389A 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 10-389A Additional Room List for Assisted Living Facilities (Alf) - Washington

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