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Get Form 07lc074e (occ-74) - Okdhs
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How to use or fill out the Form 07LC074E (OCC-74) - Okdhs online
Filling out the Form 07LC074E (OCC-74) online is essential for requesting an extension of time to comply with specific criteria. This guide provides a clear, step-by-step approach to help you complete this form efficiently and accurately.
Follow the steps to successfully complete Form 07LC074E (OCC-74) online.
- Press the ‘Get Form’ button to access the form and open it in your preferred editor.
- Fill in the facility name at the top of the form. Ensure that it matches the licensed name of your facility.
- Input your mailing address, including the area code and phone number. This information is crucial for communication regarding your request.
- Enter the city, state, and zip code where your facility is located.
- Identify your licensing specialist and include their name in the corresponding field.
- Record your license number accurately, as it ties your request to your facility operations.
- Make sure to indicate the reasons for requesting an extension by checking all applicable boxes related to the star criteria violation. Clearly define what additional time is needed to address the criteria.
- In the section for Star Criteria Violations, provide detailed reasons why you are unable to meet the requirements. Be specific and concise.
- Document the current plan of correction expiration date to give context for your extension request.
- Indicate the anticipated date you expect to meet the criteria. This sets a realistic timeline for resolution.
- Clearly describe your plans for meeting the criteria in the designated section. Be comprehensive and specific.
- Attach all supporting documents necessary to substantiate your request, such as training certificates or letters from the accrediting agency.
- After ensuring all fields are filled out correctly, you can save your changes, download the form, or print a copy. Review it carefully before submitting.
Complete your documents online today for a seamless filing experience.
The Oklahoma Department of Human Services (DHS) is overseen by a combination of state officials and regulatory agencies. The Governor of Oklahoma has significant authority, while various commissions provide oversight to ensure the agency meets its goals. If you’re navigating a situation involving DHS, using Form 07LC074E (OCC-74) - Okdhs can help you articulate your concerns and facilitate communication with the proper authorities.
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