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DP HHS HAD/CRL005 (REV 12/17) Page 1 of 2STATE OF MONTANA DEPARTMENT OF PUBLIC HEALTH AND HUMAN SERVICESQuality Assurance Division COMMUNITY RESIDENTIAL LICENSING PROGRAM PERSONAL STATEMENT OF HEALTH

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What is community residential statement of?

Community residential statement of is a report that provides information about the residency of individuals living in a community setting.

Who is required to file community residential statement of?

Community residential statement of must be filed by community residential facilities and organizations that provide housing for individuals.

How to fill out community residential statement of?

Community residential statement of must be filled out with accurate information about the residents living in the community setting, including their names, ages, and duration of stay.

What is the purpose of community residential statement of?

The purpose of community residential statement of is to track the residency status of individuals living in community settings and ensure compliance with regulations.

What information must be reported on community residential statement of?

Information such as names, ages, and duration of stay of residents must be reported on community residential statement of.

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