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  • Resident Information And Identification Record Sheet

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AFCRESIDENT INFORMATIONAND IDENTIFICATION RECORD Michigan Department of Licensing and Regulatory Affairs Division of Adult Foster Care Licensing Instructions: 1. Please complete all applicable information.

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How to fill out the Resident Information And Identification Record Sheet online

Completing the Resident Information And Identification Record Sheet is essential for documenting important details about a resident's admission. This guide provides clear instructions to help you navigate the process effectively and ensure all necessary information is accurately recorded.

Follow the steps to complete the form accurately

  1. Press the ‘Get Form’ button to access the document and open it in the online editor.
  2. Enter the license number in the designated field. This number identifies the facility offering foster care.
  3. Fill in the resident's name as it appears on their legal identification.
  4. Provide the case number associated with the resident, if applicable.
  5. Enter the social security number of the resident, ensuring confidentiality and accuracy.
  6. Indicate the veteran status and number if the resident has served in the military.
  7. Select the marital status from the provided options.
  8. Input the resident's home address, including street, city, and zip code.
  9. Fill in the date of birth for accurate identification purposes.
  10. Record the name and contact information of the next of kin, guardian, or designated representative.
  11. Enter a telephone number where the resident can be reached.
  12. Specify the resident's sex, ensuring that all entries align with provided options.
  13. Input the address of the placing agency or person, including street, city, and zip code.
  14. Provide the date of admission to the facility.
  15. If applicable, fill in the date of discharge.
  16. Record the name and contact information of the resident's physician.
  17. Enter the name of the preferred hospital along with its address.
  18. Indicate the resident's religious preference, if any.
  19. Fill out insurance information and any burial provisions as necessary.
  20. Complete the resident valuables inventory on page 2, documenting all items accurately.
  21. After ensuring all sections are filled out correctly, save your changes. You can download, print, or share the completed form as needed.

Complete the Resident Information And Identification Record Sheet online today for comprehensive record-keeping.

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You must submit form BCC-979 with your plans. This form, and the fire safety administrative rules for AFC's of 7 or more, may be obtained by visiting the LARA-BCCFS website. The local health authority completes inspections for private water supply and/or sewage disposal systems for family and group homes.

You can only receive residents in your group home after you have been granted a license by the State of Michigan. After you receive the license, you must continue to comply with the same requirements you had to meet to obtain your first license. Your license lasts for two years.

You must submit form BCC-979 with your plans. This form, and the fire safety administrative rules for AFC's of 7 or more, may be obtained by visiting the LARA-BCCFS website. The local health authority completes inspections for private water supply and/or sewage disposal systems for family and group homes.

You must file an application with the state, which will review the application and provide a license if you satisfy all criteria for your type of adult foster care home. The state wants to determine whether you can handle emergencies and whether you have the appropriate temperament to care for the elderly.

The Department of Licensing and Regulatory Affairs provides licensing and regulation of homes for the aged (HFA) and adult foster care (AFC).

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Fill Resident Information And Identification Record Sheet

Please complete all applicable information on form at the time of the resident's admission. 2. A Resident Information Form is a form template designed to collect essential information from individuals residing in a specific housing facility. This statement is located on the Resident. A file will be maintained on each family admitted to the Center. Each file will include all documents, forms, and other information specified herein.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232