5-015.34 APS Forms

473 NAC 5-015.34

Staff shall use the following forms as necessary in receiving and reporting complaints of alleged adult abuse/neglect:

1. Form DSS-1650A, "Abuse/Neglect Hotline Intake Form" (473-000-120);

2. Form DSS-76, "Client Assessment Tool" (473-000-38);

3. Form DSS-60, "Adult Abuse/Neglect Report" (473-000-39); and

4. Form DSS-0926, "Request for State Health Department Investigation of Unlicensed Facility or Adult Abuse/Neglect" (473-000-80).