Exhibit E "Staffing" - Connecticut

What Is Exhibit E?

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

Form Details:

  • Released on January 1, 2015;
  • The latest edition provided by the Connecticut State Department of Public Health;
  • 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 Exhibit E by clicking the link below or browse more documents and templates provided by the Connecticut State Department of Public Health.

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Download Exhibit E "Staffing" - Connecticut

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EXHIBIT E
STAFFING
Date
Date
Date
Shift
to
Shift
to
Shift
to
Names/Lic or Reg #’s
Names/Lic or Reg #’s
Names/Lic or Reg #’s
:
RNs
LPNs
:
:
NAs
Page 1
S:flis/hsr/strikes2015/contingencyplanstaffing 2/05/09, 12/10, 1/15
EXHIBIT E
STAFFING
Date
Date
Date
Shift
to
Shift
to
Shift
to
Names/Lic or Reg #’s
Names/Lic or Reg #’s
Names/Lic or Reg #’s
:
RNs
LPNs
:
:
NAs
Page 1
S:flis/hsr/strikes2015/contingencyplanstaffing 2/05/09, 12/10, 1/15
EXHIBIT E
STAFFING
Date
Date
Date
Shift
to
Shift
to
Shift
to
Names/Lic or Reg #’s
Names/Lic or Reg #’s
Names/Lic or Reg #’s
Adm:
:
DNS
:
ADNS
:
PT
:
OT
Sp. Th:
:
Rec
Soc.
Wk:
Food
Serv.
Sup:
Dietary
Aides:
Hskprs
:
Maint:
:
Laund
Page 2
S:flis/hsr/strikes2015/contingencyplanstaffing 2/05/09, 12/10, 1/15
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