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- To provide a documentation that the adult foster home has been inspected for safe and sanitary conditions.
Note: Form 2329 is used only when local health authorities are unable to inspect the foster home.
- To provide documentation that the adult foster home complies with the health inspection requirement in the "Minimum Standards for Adult Foster Care."
When to Prepare
The caseworker or person designated to conduct the inspection completes Form 2329 before the foster home is certified and yearly thereafter.
Number of Copies
Complete an original and one copy of Form 2329.
File the original Form 2329 in the adult foster care provider's case folder and send the copy to the provider.
The caseworker keeps the form for three years and 90 days.
Provider Name— Enter the applicant/provider's name.
Address— Enter the address of the adult foster home.
Items 1-32— Check YES or NO to indicate compliance or noncompliance with health and safety standards. If the item is not applicable, check NA and give a brief explanation in the comments section.
Person Conducting Inspection Signature— The caseworker or person designated to conduct the inspection signs and dates the form.
Title— The person conducting the inspection prints his job title.