Get Ca Dhcs 5078 2013-2026

The CA DHCS 5078 form is essential for documentation regarding centrally stored medication and destruction records in healthcare facilities. This guide will help you navigate the form accurately and confidently.

Follow the steps to complete the CA DHCS 5078 form online.

1. Press the ‘Get Form’ button to access the form and open it in your browser.
2. Begin by entering the resident's name in the designated field. Ensure that you provide the full and correct name to maintain accurate records.
3. Input the admission date of the resident. This date is crucial for tracking medication administration and disposal timelines.
4. Enter the facility name in the appropriate field. This identifies the organization responsible for the resident's care.
5. Fill in the attending physician's name, ensuring it matches records maintained by the facility.
6. Complete the facility ID number field. This unique identifier aids in streamlining records.
7. Provide the program director’s name, as they oversee the administration of medications and record-keeping.
8. Under the 'centrally stored medication' section, list each medication name. Include strength or quantity, expiration date, date filled, and the prescribing physician’s information.
9. For the medication destruction record section, document the medication names that require disposal, along with the relevant strength or quantity, date filled, prescription number, and disposal date.
10. Finally, ensure that both the administrator’s signature and a witness signature are present to validate the records.
11. Once all fields are completed, review your entries for accuracy. After confirming, you can save changes, download, print, or share the form as necessary.

Complete your CA DHCS 5078 form online today for efficient and compliant documentation.