Form LIC 9119 EBSH. Facility Inspection Checklist Enhanced Behavioral Supports Homes - California

Form LIC 9119 EBSH serves as a Facility Inspection Checklist specifically designed for Enhanced Behavioral Supports Homes (EBSH) in California. This checklist is utilized during inspections conducted by representatives from the California Department of Social Services to assess the compliance of EBSHs with state regulations and licensing requirements.

The form consists of various sections that cover different areas of operation, including staff qualifications, behavior management plans, health and safety measures, physical environment, recordkeeping practices, program activities, and documentation requirements. It is important for EBSH operators to thoroughly review and complete each section of the checklist to ensure compliance with the regulations set forth by the California Department of Social Services.

When filling out the form, EBSH operators should focus on accurately documenting staff qualifications and training requirements, developing comprehensive behavior management plans, implementing appropriate health and safety measures, maintaining a suitable physical environment, keeping comprehensive records, providing appropriate program activities, and meeting all necessary documentation requirements. By utilizing this checklist, EBSHs can proactively identify areas for improvement and maintain compliance with the California Department of Social Services' regulations.

Application Example: An Enhanced Behavioral Supports Home in California conducts regular self-inspections using Form LIC 9119 EBSH. The home reviews its staff qualifications and training requirements, assesses the effectiveness of behavior management plans, evaluates health and safety practices, checks the suitability of the physical environment, ensures the completeness of records, provides appropriate program activities, and meets all necessary documentation requirements. By utilizing the checklist, the Enhanced Behavioral Supports Home can identify any deficiencies and make necessary improvements to maintain compliance with state regulations.