F-62381 - Wisconsin Department of Health Services - Wisconsin.gov - dhs wisconsin 2025

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The document is a compliance statement required by the Wisconsin Department of Health Services for certification or registration as a Residential Care Apartment Complex (RCAC). It outlines the necessary regulations and operational codes that facilities must adhere to, including policies on tenant health and safety, staffing requirements, and compliance with local building codes. The form must be completed and submitted to the Division of Quality Assurance, confirming adherence to various statutes and regulations.

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Click ‘Get Form’ to open it in the editor.
Begin by entering the facility's name and address in the designated fields. Ensure accuracy as this information is crucial for identification.
Fill in the name of the person completing the form along with their telephone number and zip code. This contact information is essential for any follow-up.
Review each compliance section carefully. Check the boxes next to each statement that confirms your facility's adherence to Wisconsin Administrative Code, DHS 89.
For each operational code, ensure that you have documented evidence ready, such as policies and procedures, staffing plans, and service agreements.
Once all sections are completed, sign and date the form at the bottom. Make sure to print your name and title clearly.

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How do I request open records for DHS Wisconsin?

Record custodian, room 618; 608-266-3816, dhswebmailopib@dhs.wisconsin.gov. The Office of the Secretary (OS): 608-266-9622, dhsosopenrecords@dhs.wisconsin.gov. All other requests can be submitted to Room 651, 608-267-5093, dhsopenrecordsrequests@dhs.wisconsin.gov.

Where do I go to apply for food stamps in Wisconsin?

How To Apply Visit ACCESS to complete an online application. Call the Great Rivers Call Center at 1-888-283-0012 and complete your application and interview over the phone. Schedule a face to face appointment by calling Great Rivers Call Center at 888-283-0012. Complete a paper application and return it one of 3 ways:

What does the Wisconsin Department of Health Services do?

Its responsibilities include public health; mental health and substance abuse; long-term support and care; services to people with disabilities, medical assistance, and childrens services; aging programs; physical and developmental disability services; blindness disability programs; operation of care and treatment

How long does it take to get approved for food stamps in Wisconsin?

Get Help Applying for FoodShare Give us a call at 1-877-366-3635 or fill out the Contact Us form on this page.

How do I speak to someone at Wisconsin FoodShare?

SNAP Income Limits Household SizeGross monthly income (130% of poverty)Net monthly income (100% of poverty) 1 $1,580 $1,215 2 $2,137 $1,644 3 $2,694 $2,0722 more rows May 22, 2025

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What is the email format for the Wisconsin Department of Health Services?

The most common Wisconsin Department of Health Services email format is [first]. [last] (ex. jane.doe@dhs.wisconsin.gov), which is being used by 99.4% of Wisconsin Department of Health Services work email addresses. Other common Wisconsin Department of Health Services email patterns are [last][firstinitial] (ex.

What is the monthly income limit for food stamps in Wisconsin?

Your application and verification documents will be sent to your local agency, who usually needs 30 days to process your application. You will complete a simple telephone interview with a caseworker so they can ask any follow-up questions.