Completion of this survey is required for all providers who receive Home and Community Based Waiver funds from Illinois Department of Human Services. The completed survey is to be returned before June 20, 2023, to DHS.BQMQE@illinois.gov. Responses will be audited by the Bureau of Quality Management during an official review of the agency. Providers are required to maintain evidence to support the information provided in the survey.
Required Training to include:
- Rule 50 every two years
- DSP Training
- CPR/First Aid every two years
The Executive Director attests by signing below that the information is accurate and complete as of the date of signature. Failure to maintain records to support the data on this form can impact funding and/or licensure or certification status.