Assisted Living Residences Forms

This page contains forms used by operators of, or applicants for, assisted living residences. Apart from the Serious Incident Report form, separate forms are used for seniors and mental health/substance use assisted living residences.

These forms are directly related to the registration and operation of assisted living residences through the assisted living registry. Operators of assisted living residences must commit to ensuring the health and safety of the residents.

Form # Form Name and Information

1622

A serious incident report form must be filled in by residence site managers after a serious incident has occurred. Serious Incidents include: attempted suicide by a resident, unexpected deaths, abuse or neglect, medication errors, fire or flood, missing persons, police calls, and other incidents that the site manager believes are serious and should be reported.

 

Seniors' Assisted Living Forms

Form # Form Name and Information

1620

This form should be submitted together with the Required Documents Checklist as well as all required information, attachments and fees at least two months before opening a seniors assisted living residence.

1621

This worksheet helps operators and applicants assess the extent to which they are offering personal assistance in any of six service areas and whether they are doing so at the prescribed level. The appropriate worksheet must be completed and submitted with the application for registration.
1624

To be submitted with the Application for Registration (for seniors assisted living residences).

 

Mental Health and Substance Use Assisted Living Forms

Form # Form Name and Information

1623

This form should be submitted together with all required information, attachments and fees at least two months before opening a mental health/substance use assisted living residence.

1624

To be submitted with the application for registration (for mental health/substance use assisted living residences).

1625

This worksheet helps operators and applicants assess the extent to which they are offering personal assistance in any of six service areas and whether they are doing so at the prescribed level. The appropriate worksheet must be completed and submitted with the application for registration.