Otter Tail County, MN otter tail county, minnesota Otter Tail County, MN otter tail county, minnesota Otter Tail County, MN otter tail county, minnesota
HOME PAGE | CONTACT US | DEPARTMENTS | MAPS | PROPERTY TAXES | CALENDAR | LINKS | HELP | ABOUT | SEARCH OPTIONS


Human Services Home


 
 



 
 

Human Services
 

Adult Foster Care Licensing

Otter Tail County Human Services is responsible for the licensing of adult foster care homes located in the county.

All adult foster care providers are subject to a background study run through the Minnesota Department of Human Services. In addition to the background studies, all prospective adult foster care homes will undergo and pass a home inspection by a State Fire Marshal prior to being licensed.

"Adult Foster Care" means the provision of food, lodging, protection, supervision, and household services to a functionally impaired adult in a residence, and may also include the provision of personal care, household and living skills assistance or training, medication assistance under part 9555.6225, subpart 8, and assistance safeguarding cash resources under part 9555.6265.

Adult Foster Care homes can be licensed for 1 or as many as 5. To be licensed for 5, all clients must be 55 and older and do not have a serious and persistent mental illness or a developmental disability.

To apply for an adult foster care license, a person must be 18 years of age, and reside in Otter Tail County.

Initial Licensing Forms
(for New Adult Foster Care Applicants only)
Adult Foster Care Relicensing Forms
pdf Background Study
pdf License Screening Form
pdf Home Safety Checklist (off site link)
pdf Resident Records Checklist
pdf Furnace Inspection in yellow
pdf Floor and Escape Plan
pdf Program Plan
pdf Guidelines to Developing A Program Abuse Prevention Plan
pdf Program Abuse Prevention Plan
pdf Chemical Usage Policy
pdf Complaint Grievance Procedure
pdf VA Maltreatment Reporting
pdf AFC Handbook
pdf Rule 203
pdf AFC Licensing Process

pdf Relicensing Checklist
pdf Notice of Privacy Practices (off site link)
pdf Family Systems Application (off site link)
pdf Relicensing Evaluation
pdf Home Safety Checklist (off site link)
pdf Well Water Testing
pdf Furnace Inspection
pdf Background Study
pdf Rule 203-Adult Foster Care Licensing Checklist
pdf Resident Records Checklist
pdf Caregiver Training Record
pdf Fire Extinguisher Reminder
pdf Why Does My Water Need To Be 120
pdf Placement Records of Adults
Adult Foster Care Client Forms
 

pdf Handbook
pdf ADL Estimation Guide
pdf Adult Foster Home Mobility Access Assessment
pdf Authorization To Release Confidential Information
pdf Cash Resource Procedure For Adult Foster Care
pdf Cash Resources Record
pdf Homes Plus Resident Personal Record
pdf Homes Plus Resident Rights & VA Law Information
pdf Incident Reports
pdf Individual Abuse Prevention Plan
pdf Individual Resident Emergency Escape Plan
pdf Individual Resident Placement Agreement
pdf Individual Resident Placement Agreement-Respite
pdf Initial Contact Screening Form
pdf Injectable Medication Administration Authorization
pdf Medical Records Request Authorization to Release Confidential Information
pdf Medication Assistance For AFC Residents
pdf Medication Information Sheet
pdf Medication Record and Assistance Administration Authorization
pdf Medication Record Instructions and Form
pdf Physicians Visit Order Form
pdf Resident Information and Discharge Form
pdf Resident Records Checklist
pdf Resident Rights for Adult Foster Care Programs
pdf Residents Personal Possessions Inventory
pdf Residents Progress Notes Incident Report
pdf Transition Checklist

 

 

United We Stand
©Copyright 2001- County of Otter Tail, Minnesota. U.S.A.
All Rights Reserved.
This web site is maintained by the Otter Tail County GIS Office.