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DEPARTMENT OF HEALTH SERVICES Division of Quality Assurance F-62671 (06/2015) STATE OF WISCONSIN ADULT FAMILY HOME (AFH) INITIAL LICENSURE CHECKLIST Name Facility Date Form Completed (MM/dd/YYY) Street
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How to fill out Wisconsin AFH forms:

01
Gather all necessary information and documents, such as the applicant's personal information, medical history, and any required supporting documentation.
02
Carefully read and understand the instructions provided with the AFH forms to ensure accurate completion.
03
Begin filling out the forms by entering the required information in the designated fields, making sure to provide accurate and complete information.
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Double-check all entries for accuracy and completeness before submitting the forms.
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If there are any sections or questions that are unclear or require further clarification, seek assistance from the relevant authority or organization.
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Once the forms are filled out, sign and date them as required.

Who needs Wisconsin AFH forms:

01
Individuals or entities planning to operate an Adult Family Home (AFH) in Wisconsin need to fill out Wisconsin AFH forms.
02
Prospective caregivers and operators who want to provide care and housing services to elderly or disabled individuals in a residential setting must complete these forms.
03
These forms are necessary for obtaining the required licenses and certifications to operate an AFH and ensure compliance with Wisconsin state laws and regulations.
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Wisconsin AFH forms are documents used for the licensing and regulation of adult family homes in the state of Wisconsin. They include information regarding compliance with state regulations for the care of residents.
Individuals or entities seeking to operate an adult family home in Wisconsin are required to file Wisconsin AFH forms with the appropriate regulatory agency.
To fill out Wisconsin AFH forms, applicants must provide detailed information about the home, including its physical layout, staff qualifications, care services offered, and compliance with health and safety regulations.
The purpose of Wisconsin AFH forms is to ensure that adult family homes meet state standards for resident care and safety, thereby protecting the health and welfare of residents.
Wisconsin AFH forms must report information such as the address of the home, owner details, staff training and background checks, resident care plans, and safety measures in place.
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