SAMPLE AFH NEGOTIATED CARE PLAN

CARE AND SERVICES RESIDENT STRENGTHS/WHAT RESIDENT PREFERS TO DO INDEPENDENTLY WHAT PROVIDER/CAREGIVER/SUPPORT PERSON DOES/WHEN & HOW COMMUNICATION: SPEECH/HEARING/VISION. Yes No Negotiated Care Plan 388-76-10355 Problems with speech. Describe: Explain how the resident is able to manage these areas. ................
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