TX HHS Form 1594. Individualized Skills Assessment for Regulating Water Temperature

Form 1594 is a safety-focused assessment document used within the Home and Community-based Services (HCS) program in Texas. The form is designed to evaluate whether an individual living in an HCS residence can safely regulate hot and cold water during bathing or handwashing without assistance. Its purpose is to prevent scalding injuries and ensure appropriate supports are in place when independent temperature control is not safe.

This assessment must be completed on an individual basis and maintained at the residence as part of required health and safety documentation.

Purpose of Form 1594

The primary purpose of Form 1594 is to determine an individual’s ability to independently control water temperature by assessing both cognitive understanding and physical ability. The results guide providers in deciding whether supervision, adaptive equipment, or other safety measures are required.

The form also serves as documented proof that the provider has evaluated and addressed a known safety risk in accordance with state requirements.

When This Form Is Required

Form 1594 must be completed:

• At least once each year for every individual residing in an HCS home
• When an individual first moves into a residence
• When there is a change in the individual’s cognitive or physical abilities
• After an incident related to water temperature safety

The form is generally not required for individuals who do not reside in an HCS setting or when water access is fully supervised at all times.

Who Is Authorized to Complete the Assessment

The assessment must be completed by a staff person who:

• Is employed by the HCS program provider
• Does not provide residential support, supervised living, or host home/companion care in the residence
• Does not work or live in the residence being assessed

This separation helps ensure objectivity and accuracy in the evaluation.

Explanation of Each Key Section

Program and Individual Information

This section identifies the program provider, contract details, the individual being assessed, CARE system ID, residence type, and location. Accurate identification ensures the assessment is linked to the correct individual and setting.

Cognitive Ability Evaluation

This section evaluates how the individual understands and responds to water temperature. It includes questions about:

• How the individual judges whether water is too hot or too cold
• What actions the individual takes if water is too hot
• How the individual responds to sudden temperature changes

Responses should be based on observed behavior, not assumptions.

Physical Ability Evaluation

This portion documents a face-to-face, competency-based evaluation of physical skills, including whether the individual can independently:

• Turn on hot water
• Turn on cold water
• Adjust water to a comfortable and safe temperature

Overall Safety Determination

Based on the cognitive and physical evaluations, the assessor determines whether the individual can regulate water temperature safely without assistance or guidance. This determination directly affects service planning and supervision requirements.

Practical Tips for Completing Form 1594

• Conduct the assessment during an actual face-to-face demonstration.
• Document observed behaviors rather than general impressions.
• Use clear, specific language when describing responses.
• Reassess promptly if abilities change.
• Store the completed form at the residence as required.

Common Mistakes to Avoid

• Allowing residential staff to complete the assessment
• Failing to observe the individual directly
• Leaving narrative responses incomplete or vague
• Not updating the assessment after a change in condition
• Misplacing the form instead of keeping it in the residence

Legal and Regulatory Context

Form 1594 is required under Texas HCS health and safety standards. State rules require providers to identify and mitigate risks related to bathing and water temperature, as scalding injuries present a serious and preventable hazard. Maintaining this assessment demonstrates compliance during reviews and inspections.

Failure to complete or maintain the assessment may result in findings during monitoring or enforcement actions.

Real-Life Situations Where This Form Is Used

• An individual moves into an HCS residence and must be evaluated for bathing safety.
• A provider notices changes in mobility or cognition that affect water use.
• An incident involving hot water prompts a reassessment.
• A compliance review requests proof of current safety assessments.

Documents Commonly Associated with This Form

• Individual Plan of Care (IPC)
• Person-Directed Plan (PDP)
• Incident reports, if applicable
• Risk mitigation or supervision plans
• Provider health and safety policies

Frequently Asked Questions

How often must Form 1594 be completed?

At least annually and whenever there is a significant change in abilities.

Does this assessment require a face-to-face review?

Yes, the evaluation must be based on direct observation.

Can residential staff complete the assessment?

No, the assessor must not work or live in the residence.

Where should the completed form be kept?

A copy must be kept in the residence.

What happens if an individual cannot regulate water safely?

Additional supervision or safety measures must be implemented.

Is this form reviewed during inspections?

Yes, it is commonly reviewed during compliance monitoring.

Related Forms

• Individual Plan of Care (IPC)
• Person-Directed Plan (PDP)
• Incident and Risk Management Forms
• HCS Health and Safety Assessments

Form Details

• Form Name: Individualized Skills Assessment for Regulating Water Temperature
• Form Number: 1594
• Program: Home and Community-based Services (HCS)
• State: Texas
• Revision Date: June 2015