TX HHS Form 2323. Assessment of Provider and Adult Foster Care Home

The TX HHS Form 2323, Assessment of Provider and Adult Foster Care Home, is a crucial document used to evaluate the qualifications and suitability of providers and adult foster care homes in Texas. This form helps ensure that these facilities meet the necessary standards for providing safe and quality care to residents.

This assessment requires providers to submit information about their qualifications, including proof of a current tuberculosis examination with negative results, as well as provide three references from non-related individuals. Providers must also attest to not being the spouse of a Texas Health and Human Services Commission (HHSC)-funded foster care resident in their care. The form also includes sections for providers to disclose any felony or misdemeanor convictions and pending criminal charges.

The TX HHS Form 2323 is typically used during the initial enrollment, renewal, or re-enrollment process of a provider or adult foster care home. It serves as a critical tool for ensuring that these facilities meet the necessary standards for providing quality care to residents. By completing this form, providers can demonstrate their commitment to meeting the needs of their residents and maintaining a safe and healthy environment.