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  • Optional Long Term Care Assessment and Care Planning Tool
    This form was created by a group of Adult Family Home providers, resident advocates, Washington State DSHS Aging and Adult Services Administration staff and professional assessors, and was designed to include the elements of an assessment required in WAC 388-76-61020
  • Comprehensive Assessment Reporting Evaluation - CARE
    How is my need for personal care services assessed in CARE? The department gathers information from you, your caregivers, family members and other sources to assess your abilities to perform personal care tasks
  • AFH Assessment Form | PDF | Memory | Urinary Incontinence
    The document provides background forms and screening tools for assessing an individual's long term care needs, including sections on medical history, medications, preferences, social factors, and screens for delirium, depression and cognition
  • Forms | DSHS
    DSHS is issuing full November food and cash benefits to people in Washington state on their usual dates In addition, we are processing new applications for benefits that were submitted after Oct 16, 2025, as quickly as possible Click here for more information
  • NURSING ASSESSMENT | I Care Nurses
    An assessment is a DSHS required document for all residents wishing to move into or who already reside in an Adult Family Home in Washington State The assessment must be done and contain accurate information about the resident’s current needs and preferences
  • Resident Assessment Templates PDF. download Fill and print for free.
    Our resident assessment forms have been developed with input from experts in the field to ensure they cover all necessary aspects of a resident's health and well-being
  • Nursing Services Assessment
    NOTE: Assessor is not expected to do a household inspection but is reporting on what is observed during visit Suspicion of abuse of neglect requires a referral to APS (in-home), CRU (licensed facilities) or CPS Observations of conditions that place the client’s health at risk: III Skin Care Issues
  • ASSESSMENT WACS | I Care Nurses
    The adult family home must ensure each resident's assessment is reviewed and updated to document the resident's ongoing needs and preferences as follows: (1) When there is a significant change in the resident's physical or mental condition;





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