Cdph 709 form 2025

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The document is a Client Accommodations Analysis form from the California Department of Public Health, designed to record and approve client accommodations for licensed care facilities. It includes sections for facility details, room specifications, approved capacities for different types of rooms, and additional information necessary for adequate accommodation.

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Click ‘Get Form’ to open the cdph 709 form in the editor.
Begin by entering the facility name, number, and address in the designated fields. Ensure accuracy as this information is crucial for identification.
Fill in the city, state, and ZIP code. This helps in locating your facility within California.
For each building, floor, and room, specify the activity and room size. Include details like floor area and approved capacity for both nonambulatory and ambulatory individuals.
In the section for common rooms (dining, recreation, etc.), provide similar details regarding their size and approved capacities.
Utilize the additional information space to note any specific accommodations such as ventilation types or important furnishings that may affect client comfort.
Finally, enter your name and date at the bottom of the form to complete it before submission.

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2008	4.8 Satisfied (106 Votes)

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