Get Ca Hhsa Dss Lic 9092 2011-2025
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How to fill out the CA HHSA DSS LIC 9092 online
The CA HHSA DSS LIC 9092 form is a crucial document for requesting a fire pre-inspection or consultation for various care facilities in California. This guide provides step-by-step instructions to help users complete the form accurately and efficiently online.
Follow the steps to fill out the CA HHSA DSS LIC 9092 form online.
- Click ‘Get Form’ button to obtain the form and open it in the editor.
- Select the type of facility you are requesting a fire inspection for by checking the appropriate box among the options provided: Community Care Facility, Residential Care Facilities for the Chronically Ill, Residential Care Facility for Elderly, or Child Day Care Facility.
- Indicate the capacity of your facility by selecting whether it serves 25 or less clients or 26 or more clients.
- If applicable, fill in the number of non-ambulatory clients at your facility in the designated field.
- Provide the facility name, address, city, and zip code in the respective fields to ensure clarity in your request.
- Enter the owner or contact person's name along with their telephone number to facilitate communication.
- Affix your signature and date the form to certify that the information provided is accurate and complete.
- Review all entries for accuracy before finalizing the form to avoid any delays in processing.
- Upon completion, users can save changes, download, print, or share the form as necessary.
Start filling out your CA HHSA DSS LIC 9092 form online today for a smooth inspection process.
While assisted living facilities are primarily regulated at the state level, there are federal guidelines that apply, especially concerning funding and treatment. The Centers for Medicare & Medicaid Services (CMS) establishes standards for facilities receiving federal funds. However, the primary enforcement of regulations falls under state agencies like the California Department of Social Services. For detailed federal and state standards, including CA HHSA DSS LIC 9092, it's beneficial to consult legal resources.
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