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Licensing Forms for Residential and Placement Programs

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Residential and Placement Required Forms

Fire Inspection Report, Open PDF file, 11.15 KB (English, PDF 11.15 KB)
Guidelines for Refresher Restraint Curricula, Open PDF file, 21.69 KB (English, PDF 21.69 KB)
Guidelines for Restraint Curricula, Open PDF file, 22.25 KB (English, PDF 22.25 KB)
Guidelines for Restraint Curricula Checklist, Open PDF file, 37.88 KB (English, PDF 37.88 KB)
Guidelines for Restraint Policy, Open PDF file, 36.03 KB (English, PDF 36.03 KB)
Health Inspection Report, Open PDF file, 15.31 KB (English, PDF 15.31 KB)
Procedures for Completing Residential Care Records Checklists, Open PDF file, 15.64 KB (English, PDF 15.64 KB)
Residential Care and Placement Programs Personnel Checklist, Open PDF file, 27.84 KB (English, PDF 27.84 KB)
Residential Care Children's Record Checklist, Open PDF file, 561.79 KB (English, PDF 561.79 KB)
Sample Physical Restraint Incident Report, Open PDF file, 14.25 KB (English, PDF 14.25 KB)
Shelter Parent Record Checklist, Open PDF file, 40.46 KB (English, PDF 40.46 KB)

Residential Facility Safety and Maintenance Checklist

Residential programs must complete a Facility Safety and Maintenance Checklist monthly and make it available to EEC upon request.

Residential Facility Safety and Maintenance Checklist - MS Word Template, Open DOCX file, 330.4 KB (English, DOCX 330.4 KB)
Residential Facility Safety and Maintenance Checklist - PDF for Printing, Open PDF file, 320.37 KB (English, PDF 320.37 KB)

Sample Forms to Help You Operate Your Residential or Placement Program

51A or Incident Reporting Checklist for Foster Care Programs, Open PDF file, 21.82 KB (English, PDF 21.82 KB)
Incident Checklist for Residential & Placement Program, Open PDF file, 18.33 KB (English, PDF 18.33 KB)

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