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Adult Family Home Disclosure of Services Required by RCW 70.128.280 ! HOME / PROVIDERLICENSE NUMBERSEQUOIA HEIGHTS ADULT FAMILY HOME, LLC752402NOTE: The term the home refers to the adult family home
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How to fill out adult family home disclosure

01
Obtain the adult family home disclosure form
02
Read the instructions carefully to understand what information needs to be provided
03
Fill out the personal information section with your name, address, and contact details
04
Provide information about the property such as the address, size, and any special features or amenities
05
Disclose any outstanding mortgages, liens, or encumbrances on the property
06
Provide details about any legal or ethical violations related to the operation of the home
07
Disclose any insurance coverage on the property
08
Attach any relevant documents or supporting evidence as requested
09
Review the completed form for accuracy and completeness
10
Sign and date the form
11
Submit the completed disclosure form to the appropriate authority or organization

Who needs adult family home disclosure?

01
Anyone operating an adult family home or planning to open one needs to fill out the adult family home disclosure. This form is typically required by regulatory agencies, licensing authorities, or organizations overseeing the operation of adult family homes.
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Adult family home disclosure is a document that provides information about a facility or home that provides care services for adults who are unable to live independently.
Any adult family home provider or facility owner is required to file adult family home disclosure.
Adult family home disclosure can be filled out by providing accurate information about the facility, services provided, and any additional required details.
The purpose of adult family home disclosure is to ensure transparency and provide potential residents or their families with essential information about the facility.
Information such as the name and address of the facility, type of care services offered, number of residents, contact information, and any violations or complaints must be reported on adult family home disclosure.
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