Get Safety 507 Form

The Safety 507 Form is an essential document designed to assess staff coverage in large residential facilities over a three-week period. This guide will provide you with step-by-step instructions for completing the form online to ensure accurate and efficient submission.

Follow the steps to complete the Safety 507 Form online.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Fill in the facility name and facility number at the top of the form, ensuring that you input accurate information as this is crucial for identification.
3. Enter the client or resident census which represents the number of individuals residing at the facility during the specified timeframe.
4. Provide the name of the licensing evaluator who is completing the form, as well as the relevant date of the report.
5. For each service area listed—such as care and supervision, food services, housekeeping, administrative/clerical, transportation/maintenance, and any other—enter the employee name(s) responsible for those areas.
6. In the work hours section, record the specific hours each employee worked on the respective days for the week, including weekends.
7. Utilize the ‘Enter Dates of Week’ fields to indicate the specific timeframe for which you are reporting, covering a full three-week cycle as required.
8. Review all information entered to ensure accuracy and completeness before moving to save or submit the form.
9. Finally, save your changes; you may also choose to download, print, or share the form as needed.

Begin filling out the Safety 507 Form online today for effective staff coverage management.