Dshs 15 456 form 2026

1. Click ‘Get Form’ to open the dshs 15 456 form in the editor.
2. In Section 1, enter the employee’s name, date of birth, facility’s name, and date of review. Indicate whether this is a new review or a renewal by checking the appropriate box.
3. Proceed to Section 2. Here, list any convictions, pending charges, negative actions, or other relevant information about the individual. Ensure you have supporting documents ready for reference.
4. In Section 3, consider suggested factors that may influence your determination regarding unsupervised access. Reflect on the vulnerability of clients and any patterns of offenses.
5. Finally, complete Section 4 by documenting your decision on whether the individual may have unsupervised access. Sign and date where indicated.

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