Texas

The TX HHS Form 1080, Health and Developmental Services (HDS) Promotion and Outreach Annual Plan, helps organizations contracted with the HHSC program plan their promotional activities and outreach strategies for the year. This form is typically used by organizations that contract with the Breast and Cervical Cancer Services (BCCS), Family Planning Program (FPP), Healthy Texas Women Cost Reimbursement (HTW CR) programs.

The TX HHS Form 1084, Certification for Warrants Lost, Destroyed, Stolen, or Not Received, is a crucial document that helps resolve issues related to Treasury warrants. This form is typically used in situations where a warrant has gone missing, been destroyed, stolen, or not received by the intended recipient. The form's primary purpose is to certify the status of the warrant and facilitate its cancellation or reissuance.

The State of Texas Emergency Assistance Registry (STEAR) Form 1085 is a crucial tool for assisted living facilities and nursing homes to register their emergency contact information. This form helps ensure that critical details are readily available in the event of an emergency, allowing for swift communication and response.

The Texas Health and Human Services (HHS) Form 1090, Oral Evaluation and Fluoride Varnish Certification Application, is a crucial document for healthcare providers in the state of Texas. This form helps solve the problem of ensuring that primary care providers are certified to administer fluoride varnish treatments to patients, particularly children, as part of oral health evaluations.

Form 1092 is an official affidavit used to document and certify a Change of Ownership (CHOW) for facilities licensed and regulated in the state of Texas. This form is required when operational control of a licensed facility is transferred from one legal entity to another. It ensures that both the outgoing and incoming owners formally acknowledge the transfer, verify the accuracy of the information provided, and meet state licensing requirements. The affidavit must be completed accurately, signed by authorized representatives of both parties, and notarized before submission.

The TX HHS Form 1099 Operational Discipline and Guidance Policy provides essential information for parents, employees, household members, and volunteers to ensure a safe and supportive environment for children. This policy outlines the guidelines for discipline and guidance in various settings, including before- or after-school programs.

Form 1100, titled Daily Building and Grounds Checklist, is a practical compliance document used by childcare providers to record daily safety and sanitation checks of their facilities. The form helps demonstrate that the childcare operation consistently maintains a safe, clean, and age-appropriate environment for children in care. Providers may use this checklist as part of their routine operational records and regulatory compliance documentation.

The TX HHS Form 1123, Review of Assisted Living Facility Type C, is a crucial document for ensuring the quality of care provided in Adult Foster Care facilities. This form helps solve the problem of verifying that facility providers meet specific qualifications and responsibilities to ensure the well-being of consumers. The form is typically used during the renewal process of a Type C Assisted Living Facility license.

The TX HHS Form 1124, Facility Request, helps resolve situations where a resident is deemed inappropriately placed in an assisted living facility. This form is used when the facility or Texas Health and Human Services (HHS) determines that a resident's needs are not being met, requiring alternative arrangements.

The TX HHS Form 1125, "Resident's Request to Remain in Facility," is a crucial document for resolving situations where a resident is determined to be inappropriately placed in an assisted living facility. This form helps address concerns by providing a mechanism for the resident or their representative to request continued residency or request assistance in remaining at the facility.