Get Notification Of Nurse Aide Abuse, Neglect, Mistreatment ... - Oklahoma - Ok

This guide provides clear and supportive instructions for completing the Notification Of Nurse Aide Abuse, Neglect, Mistreatment form in Oklahoma. By following these steps, you will ensure that all necessary information is accurately captured.

Follow the steps to complete the form accurately and efficiently.

1. Click the ‘Get Form’ button to access the document and open it in the editing interface.
2. Begin by indicating whether the report pertains to a nurse aide or a nontechnical service worker by checking the corresponding box.
3. Print or type all information clearly to ensure legibility. Fill in the 'Facility Type' and 'Date' fields with the appropriate information.
4. In the 'Facility ID' field, enter the identification number of the facility. Next, provide the 'Name of Facility' followed by the complete 'Address,' including 'Street or P.O. Box,' 'City,' 'County,' and 'Zip' code.
5. Include the name and contact information of the 'Administrator or Reporting Party,' ensuring to fill out the 'Telephone' number.
6. Provide the 'Employee Name' along with their complete address. Fill in the 'SSN' and 'Certification Number' fields accurately.
7. Indicate whether the employee was suspended by checking 'Yes' or 'No.' If suspended, input the 'Employee Suspension Date.' Similarly, indicate if the employee was terminated and provide the 'Employee Termination Date' if applicable.
8. Add the contact details of another 'Contact Person' if necessary, including their 'Telephone' number and address.
9. Detail the allegations or facts of abuse, neglect, or misappropriation of resident property in the provided section. You may attach additional sheets or reports if more space is needed.
10. Once all sections are complete, review the information for accuracy. After confirming everything is filled out correctly, you can save the changes, download the form, print it, or share it as required.

Complete your documents online today for a streamlined process.