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Protecting, Maintaining and Improving the Health of All MinnesotansState Rapid Response Investigative Public Report Officeof HealthFacilityComplaintsMaltreatment Report #: HL37996003M Compliance #: HL37996004CDate Concluded: October 10, 2022Name, Address, and County of Facility Investigated: Belevo Health Services LLC 1064 Dale Street St. Paul, MN 55117 Ramsey CountyFacility Type: Assisted Living Facility (ALF)Evaluators Name: Lori Pokela R.N. Special InvestigatorFinding: Inconclusive Nature
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01
Obtain the maltreatment report form HL37996003M from the relevant authority or website.
02
Read the instructions carefully to understand the required information.
03
Fill out the Section 1: Reporting Person Information with your personal details.
04
Complete Section 2: Information about the Victim with the victim's information.
05
In Section 3: Information about the Alleged Perpetrator, provide details of the individual suspected of maltreatment.
06
Fill out Section 4: Nature of Maltreatment, being specific about the incidents and any evidence.
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In Section 5: Additional Information, include any other relevant details that may assist in the investigation.
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Review the completed form for accuracy and completeness.
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Submit the report according to the instructions provided, ensuring it reaches the responsible agency.

Who needs maltreatment report hl37996003m?

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Individuals or agencies that suspect maltreatment of a child, elderly person, or dependent adult.
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Professionals mandated by law to report instances of abuse or neglect, such as teachers, doctors, and social workers.
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Family members or friends who notice signs of maltreatment and wish to report their concerns.
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Maltreatment report hl37996003m is a formal document used to report instances of abuse or neglect, ensuring that concerns about the safety and well-being of individuals, often children or vulnerable adults, are addressed by the appropriate authorities.
Individuals who are mandated reporters, such as teachers, healthcare professionals, social workers, and caregivers, are required to file maltreatment report hl37996003m when they suspect maltreatment.
To fill out maltreatment report hl37996003m, gather all relevant information about the suspected maltreatment, including details about the victim, the alleged perpetrator, the nature of the abuse, and any witnesses. Complete all sections of the report accurately and submit it to the designated authority.
The purpose of maltreatment report hl37996003m is to facilitate the reporting of suspected abuse or neglect to appropriate authorities, helping to ensure that individuals at risk receive protection and necessary interventions.
Maltreatment report hl37996003m must include information such as the names and contact details of the victim and alleged perpetrator, the nature of the maltreatment, the context in which it occurred, and any available evidence or eyewitness accounts.
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