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Free working sample

Florida Adult Day Care Pre-Survey Readiness Snapshot

A short example of how the full kit organizes evidence. This is a planning aid, not a substitute for the current regulations or AHCA survey materials.

Facility: ____________________Review date: ____________________Reviewer: ____________________

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1. Governance

Owner/operator designation documented; lines of authority visible; substitute operator identified.

Evidence location / action needed

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2. Participant files

Health statement timing checked; emergency release present; medications, diet, mobility, and responsible-party details current.

Evidence location / action needed

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3. Personnel files

Required screening, health statements, qualifications, orientation, CPR/first aid, and training evidence filed.

Evidence location / action needed

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4. Operations

Daily attendance, activity schedule, nutrition records, incident workflow, complaint process, and medication assistance records ready.

Evidence location / action needed

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5. Physical environment

Participant capacity, usable activity space, rest area, bathrooms, accessibility, sanitation, and postings checked.

Evidence location / action needed

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6. Emergency readiness

Facility-specific plan, contacts, staff roles, evacuation routes, drills, continuity steps, and local coordination documented.

Evidence location / action needed

How the complete version differs

The paid product is planned to map individual checklist items to source citations and matching editable documents, with customization prompts and document-control fields.

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