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Housing Safety and Accessibility Forms

Accessibility Standards and Checklist (Pre-Inspection) - The Accessibility Standards and Checklist is used by the agencies for the pre-inspection of a home, prior to contacting the DAIL Home Contractor to schedule a Accessibility Assessment.  (See the

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Home Safety Assessment Request for Housing Contractor

26 January 2021

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Documentation of Chimney Cleaning and Inspection by Non-Professional Form

13 July 2020

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Return to Employment Services Assessment Tool

10 June 2020

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Return to Community Activities Assessment Tool

10 June 2020

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COVID Payment Authorization Form

15 May 2020

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Individual Support Agreement (ISA) COVID-19 Form

13 May 2020

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Living Out-of-State Report Form for DS Home and Community Based Services (HCBS)

05 September 2019

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Sex Offender Treatment Intervention and Progress Scale (SOTIPS) Score Sheet

01 January 2013

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DAIL Risk Assessment Other Behavior Worksheet

05 February 2018

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