Get La Dhh Oaas-pf-10-014 2010-2025

This guide provides clear, step-by-step instructions on how to fill out the LA DHH OAAS-PF-10-014 form, a critical incident report for home and community-based services. By following these directions, you will ensure that all necessary information is accurately captured and submitted.

Follow the steps to complete the form effectively.

1. Press the ‘Get Form’ button to access the form and open it in your chosen browser.
2. Begin by filling in the participant identifying information. Include their first, middle (if known), and last names, along with their address, city, state, telephone number, region, date of birth, social security number, parish, and gender.
3. Next, provide the name and contact information for the family or legal guardian of the participant, including their telephone number and address.
4. Indicate the service type that applies to the participant by selecting the appropriate option: EDA, ADHC, ARC, or CC.
5. Select the marital status and race of the participant from the designated options provided.
6. Describe the living situation of the participant, ensuring to select the most accurate option from the living situation list, which includes categories like ‘With Relatives,’ ‘Alone,’ or ‘In Licensed Facility.’
7. State the disability status of the participant by marking the applicable type(s) of disability from the options given.
8. In the incident information section, enter details of the incident, including the date and time it occurred and when it was discovered.
9. Document the location of the incident, if it was at home, in the community, or in a facility, and note if any notifications were made to the direct service provider, law enforcement, or other relevant parties.
10. Complete the critical incident description by providing detailed information regarding the incident. Be as specific as possible and include any necessary follow-up actions or reports.
11. Once you have filled out all sections of the form, you may save your changes, download the form for your records, print it, or share it as required.

Start completing your LA DHH OAAS-PF-10-014 form online today.