№ lp_2_1_17505
File format: docx
Character count: 15667
File size: 51 KB
Checklist and documentation form for annual fire safety inspection in community-based residential facilities, including evaluation of emergency plans, exit routes, combustible materials, heating equipment, fire extinguishers, and smoke detection systems.
Year:
2009
Region / City:
Wisconsin, USA
Document Type:
Inspection Form
Authority:
Department of Health Services, Division of Quality Assurance
Legal Reference:
DHS 83.47(3), Wisconsin Administrative Code
Target Audience:
Facility administrators and fire inspectors
Scope:
Annual fire safety and extinguisher compliance for CBRFs
Date of Revision:
April 2009
Price: 8 / 10 USD
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The product description is provided for reference. Actual content and formatting may differ slightly.
Year:
2017
Region / City:
Wisconsin
Theme:
Licensing process for community-based residential facilities (CBRF)
Document Type:
Application form
Organization / Institution:
Department of Health Services, Division of Quality Assurance
Author:
Department of Health Services
Target Audience:
New CBRF providers
Period of Validity:
Not specified
Approval Date:
Not specified
Date of Amendments:
Not specified
Year:
Not specified
Region / City:
Wisconsin
Topic:
Multi-Function Devices, Single Function Printers, Scanners, Software
Document Type:
Contract
Organization / Institution:
Ricoh USA Inc
Author:
Not specified
Target Audience:
Not specified
Effective Period:
Not specified
Approval Date:
Not specified
Amendment Date:
Not specified
Context:
This is a contract document detailing the terms, pricing, and authorized resellers for various office equipment and services under a NASPO Master Agreement with Ricoh USA.
Year:
2023
Region / City:
Wisconsin, Madison
Subject:
Public Utility Case Participation and Compensation
Document Type:
Application Form
Authority / Institution:
Wisconsin Public Service Commission
Governing Law:
Wis. Stat. § 196.31, Wis. Admin. Code ch. PSC 3
Applicant Type:
Individual or Organizational
Required Information:
Applicant details, organizational structure, case interest, qualifications, proposed participation, budget, financial impact
Date Issued:
August 2023
Deadline / Period:
Current fiscal year (July – June)
Filing Method:
Electronic Records Filing System (ERF)
Year:
2023
Region / City:
Madison, Wisconsin
Topic:
Organization Rules and Membership Guidelines
Document Type:
Rules and Regulations
Author:
Wisconsin Organization of Furries
Target Audience:
Students and alumni of UW-Madison, MATC, and Edgewood College who self-identify as furries
Effective Period:
Ongoing
Approval Date:
2023
Date of Amendments:
None listed
Document number:
DTCP-BWM-005
Revision:
3/2025
Issuing authority:
Wisconsin Department of Agriculture, Trade and Consumer Protection
Division:
Bureau of Weights and Measures
Jurisdiction:
State of Wisconsin
Legal basis:
Wisconsin Stat. §§ 15.04(1)(m), 93.06(1)(a), 93.07(2)
Public records status:
Subject to Wisconsin Public Records Law (Wis. Stat. §§ 19.31–19.39)
Document type:
Government complaint form
Scope:
Gas pump accuracy and fuel quality complaints
Submission methods:
Mail and email
Intended complainant:
Consumers
Confidentiality option:
Anonymous submission available
Contact office address:
Madison, Wisconsin
Year:
2022
Region / City:
Wisconsin
Subject:
Estate Administration
Document Type:
Guide
Institution:
Wisconsin Register in Probate Association
Author:
Wisconsin Register in Probate Association
Target Audience:
Individuals involved in estate administration
Effective Period:
October 2022
Approval Date:
October 2022
Modification Date:
October 2022
Year:
2025
Region / City:
Wisconsin / Milwaukee
Document Type:
Plan Approval Application
Regulatory Reference:
Wis. Stat. §§ 50.02(2)(b)1, 50.025, 50.36(2)(a), 50.90(3m)
Responsible Agency:
Department of Health Services, Division of Quality Assurance
Target Facilities:
Hospitals, Hospices, Long Term Care Facilities, Free-Standing Emergency Departments, Ambulatory Surgery Centers, Medical Office Buildings, ESRD Units
Submission Requirements:
Digital and physical application forms, project plans, specifications, and associated fees
Fee Information:
Based on project scope, area, and type of review
Contact:
DQA Office of Plan Review and Inspection (OPRI), Phone: 414-227-4085, Email: [email protected]
Project Components:
Construction class, occupancy type, fire protection systems, essential building systems, structural components
Owner / Designer Information:
Required for plan approval, includes attestations for compliance
Reference:
Department of Safety and Professional Services (DSPS) for specialized systems
Scope:
State-level plan review separate from local permits
Year:
2025
Jurisdiction:
Wisconsin
Country:
United States
Document type:
Audit reporting requirements and reporting form
Program:
Managed Long-Term Care
Administering authority:
Department of Health Services, Division of Medicaid Services
Form number:
F-02022
Date of issue:
11/2025
Applicable entities:
Managed Care Organizations (MCOs)
Audit performer:
Independent certified public accountant (CPA) firm
Audit scope:
Claims processing for long-term care, acute, and primary services
Minimum sample size:
70 LTC claims; 85 total claims for FCP and PACE programs
Effective policy reference:
Residential services encounter reporting effective 02/01/2021
Coverage systems referenced:
ForwardHealth, DHS data warehouse
Year:
2026–2029
Region / City:
Wisconsin
Topic:
Emergency Medical Technician Continuing Education
Document Type:
Form
Authority / Organization:
Department of Health Services, Division of Public Health
Author:
Department of Health Services
Target Audience:
Licensed Emergency Medical Technicians (EMTs)
Validity Period:
July 1, 2023–June 30, 2026
Approval Date:
Not specified
Date of Amendments:
Not specified
Year:
2023
Region / city:
Wisconsin
Subject:
Small Claims Court Procedures
Document type:
Guide
Issuing body:
Wisconsin Court System
Author:
Wisconsin Court System
Target audience:
General public, individuals involved in small claims
Effective period:
N/A
Approval date:
N/A
Modification date:
N/A
Year:
2024
Region / City:
Wisconsin
Topic:
Fiscal and Internal Control Practices
Document Type:
Audit Guide
Organization / Institution:
Wisconsin Department of Public Instruction
Author:
Wisconsin Department of Public Instruction
Target Audience:
Schools participating in the Milwaukee, Racine, and Wisconsin Parental Choice Programs
Effective Period:
2024-2025
Approval Date:
December 15, 2024
Date of Changes:
N/A
Contextual Description:
Guide providing procedures for auditors to evaluate fiscal and internal control practices in schools participating in Wisconsin’s Parental Choice Programs, including compliance and reporting requirements.
Jurisdiction:
Wisconsin, United States
Type of Document:
Court Form
Subject:
Family Law, Paternity, Marriage, Child Placement
Parties:
Petitioner/Joint Petitioner A, Respondent/Joint Petitioner B
Case Number:
Specified in form
Court:
Circuit Court
Includes:
Notice of Hearing, Motion to Enforce Physical Placement Order
Instructions:
Filing and service procedures, legal warnings, representation rights
Jurisdiction:
Wisconsin, United States
Subject:
Civil rights compliance in federally funded programs and activities
Document type:
Administrative requirements and compliance guidance
Issuing agencies:
Wisconsin Department of Health Services; Wisconsin Department of Children and Families
Compliance period:
January 1, 2022 – December 31, 2025
Issue date:
December 2021
Revision date:
March 2024
Applicable recipients:
Recipients and subrecipients of federal financial assistance administered by DHS and DCF
Legal basis:
Federal civil rights laws applicable to HHS- and USDA FNS-funded programs
Required instruments:
Civil Rights Compliance Letter of Assurance; Civil Rights Compliance Plan
Publication identifiers:
DCF-P-153; DHS P-00164
Accessibility provisions:
Alternative format available upon request through DHS and DCF contact channels
Year:
2016
Region / City:
Wisconsin
Subject:
Substance use disorder treatment
Document Type:
Form
Agency:
Department of Health Services, State of Wisconsin
Author:
Division of Care and Treatment Services
Target Audience:
Health professionals involved in substance use treatment assessments
Period of Validity:
N/A
Approval Date:
N/A
Amendment Date:
N/A
Year:
2019
State:
Wisconsin
Program:
IRIS
Subject:
One-time expense requests
Document type:
Participant education and acknowledgement form
Form number:
F-01205C
Issuing authority:
Department of Health Services, Division of Medicaid Services
Eligibility criteria:
IRIS program participation requirements
Reviewing body:
Department of Health Services
Required signatories:
Participant, Guardian (if applicable), IRIS Consultant
Year:
2018
Region / State:
Wisconsin
Document type:
Administrative form template
Issuing body:
Department of Health Services, Division of Public Health
Form number:
F-00615A
Publication date:
May 2018
Intended organizations:
Aging and Disability Resource Centers
Subject area:
Change management in public health services
Methodological framework:
Plan, Do, Study, Act (PDSA)
Focus areas:
Service improvement, customer outcomes, programmatic and financial impact
Target population:
ADRC customers
Administrative level:
State government
Zoning districts:
R-10, R-12, R-21, R-29
Document type:
Zoning regulations
Land use category:
Residential
Density standards:
Maximum dwelling units per acre by district
Minimum lot size:
Single-family and multi-family requirements
Building height limits:
By district and proximity to property lines
Setback requirements:
Street, side, and rear setbacks
Lot coverage limits:
By dwelling type and open space provision
Open space requirements:
Common and private open space standards
Accessory dwelling units:
Private open space criteria
Referenced code sections:
14-7.2, 14-7.5
Regulatory source:
Municipal zoning code
Note:
Year
Topic:
Residential Districts Planning
Document Type:
Zoning Regulation
Note:
Year
City:
Englewood
Document Type:
Rent Adjustment Notice
Department:
Building Department