Information for AFH Prospective Providers

Yes, you will have to be Home Care Aide Certified UNLESS you meet one of the following exemptions:

• RNs, LPNs, and certified nursing assistants (NA- C/CNA) or persons in an approved CNA training program;
• Medicare certified home health aides;
• Person with special education training and an endorsement granted by the Superintendent of Public Instruction; or
• Employed as a LTC worker sometime between 1/1/2011 and 1/6/2012 AND who completed the training requirements in effect at the time.  Must have proof of that employment meeting the requirements of DOH WAC 246-980-070.

If you do not meet one of those exemptions, you must complete the seventy-five hour orientation, safety, and basic training requirements, take the home care aide certification examination, and receive certification from the Department of Health prior to applying for an adult family home license. Find an approved training program here.

• Local Building Code Inspections Checklist
• A floor plan for each level of the home will also need to be submitted with the building inspection checklist and the AFH Application.
• State licensing Initial Inspection Preparation Checklist – AFH Initial Inspection Preparation Checklist

If your home is on a septic system, the system will need to be inspected by your local health authority or approved septic system inspection entity and you will need to provide documentation of the following:

• The septic system has been inspected and approved
• How many people (not bedrooms) the system can accommodate
• The local health authority or inspection entity is aware that the system will be used in an AFH

This information does not need to be submitted with the application but it will need to be provided to the licensor prior to licensure recommendation. There can be significant costs associated with septic system improvements, so it is highly recommended this process be completed prior to submitting the application.

Administration records: You must have a system to maintain your administrative records. Your system must include the following documents:

• Orientation Checklist
• Evacuation Drill -  
• Accident/Injury Log
• Policies
  • Medication Disposal -
  • Abuse, Neglect, Exploitation
  • Contacting Emergency Services
  • Medicaid Policy
• Disaster Plans
  • Emergency Preparedness Workbook for AFHs
  • Emergency Planning Information
  • AFH Response to Natural or Human-Made Disaster
• Notice of Rights and Service Requirements
• Liability Insurance

Resident records: You must have a system to maintain confidential resident records so you can provide the needed care to the residents.  Your system must be organized so there is a place for the following documents:

• Personal Belongings Inventory Log DSHS 02-516 
• Resident Assessment/Preliminary Service plan
• Negotiated Care Plan
• Medical Professional Orders
• Legal Documents
• Financial Record Keeping
• Resident Information Sheet
• Nurse Delegation documents:
  • Nursing Assistant credentials and Training DSHS 10-217 
  • Consent for Delegation Process DSHS 13-678
  • Instructions for Nursing Task DSHS 13-678
  • Nursing Visit DSHS 14-484
  • Change in Medical Orders DSHS 13-681
  • PRN Medication DSHS 13-678A
• Medication Logs - MARS