AGING AND DISABILITY SERVICES ADMINISTRATION
Reporting and Recording Tasks
DSHS requires you to report quarterly what training you have done for all DSHS required classes. Student evaluation or summaries of student evaluations are also required. Download and use the appropriate form below and send your completed report to:
Training, Communications & Development Unit
P.O. Box 45600
Olympia, WA 98504-5600
E-mail: TrainingReports@dshs.wa.gov
FAX: 360-725-2646
Questions? Call 360-725-2548
Caregiver classes
Basic training, modified basic training, Nurse Delegation, Caregiver Dementia, Caregiver Mental Health, Caregiver Developmental Disabilities.
- Caregiver Class Reporting Form
- Revised Fundamentals of Caregiving Student Evaluation Summary form (PDF Format)
- Modified Fundamentals of Caregiving Student Evaluation Summary (PDF Format)
- Nurse Delegation Student Evaluation Summary form (PDF Format)
Manager specialty training
- Manager Dementia Training Attendance (PDF Format)
- Manager Mental Health Training Attendance (PDF Format)
- Manager Dementia Training Evaluation (PDF Format)
- Manager Mental Health Training Evaluation (PDF Format)
Updating Training Information
- Adult Family Homes and Boarding Homes
Once you are approved to offer training at your facility, you must notify DSHS in writing if any information from your original Facility Based Training Form changes (e.g. adding a new instructor, classes, new contact information).- Facility Based Training Update Form (Word Format)
- Facility Based Training Update Form (PDF format)
- Community Educators
You must fill out, sign, and send in a Memorandum of Understanding (M.O.U.) Update Form each year. This extends your M.O.U. for one year from the date that your completed form is signed by you, received in Olympia, and signed by an HCS official.
