Va Form 10-0388-3 - State Home Construction Grant Program Space Program Analysis - Nursing Home & Domiciliary

Download a blank fillable Va Form 10-0388-3 - State Home Construction Grant Program Space Program Analysis - Nursing Home & Domiciliary in PDF format just by clicking the "DOWNLOAD PDF" button.

Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.

Complete Va Form 10-0388-3 - State Home Construction Grant Program Space Program Analysis - Nursing Home & Domiciliary with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.

Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.

ADVERTISEMENT

OMB Number 2900-0661
Estimated Burden: 6 hours
STATE HOME CONSTRUCTION GRANT PROGRAM
SPACE PROGRAM ANALYSIS - NURSING HOME & DOMICILIARY
PROJECT LOCA TION
FAI#
NUMBER OF BEDS IN PROJECT
PROJECT NA M E:
PROPOSED BY
TOTAL VA
TOTAL VA
1. SUPPORT FACILITIES
1. SUPPORT FACILITIES
1. SUPPORT FACILITIES
1. SUPPORT FACILITIES
VA CRITERIA
STATE
STATE
ALLOWED
ALLOWED
200
ADMINISTRATOR' S OFFICE
150
ASST. ADMINISTRATOR
MEDICAL OFFICER, DIRECTOR OF NURSING OR EQUIVALENT
150
120
NURSES' OFFICE AND DICTATION AREA
(each office/person)
120
GENERAL ADMINISTRATION
120
120
120
120
120
120
120
120
120
MAY INCLUDE: MEDICAL RECORDS
120
SOCIAL SERVICES
120
RECEPTION / INFORMATION
80@
CLERICAL STAFF (Each) #
40
COM PUTER A REA
500
CONFERENCE ROOM / CONSULTATION AREA / IN-SERV ICE TRAINING
3/BED
LOBBY/WAITING AREA
(150 min. 600)
25/FIXTURE
PUBLIC TOILETS (MALE, FEMALE)
AS REQUIRED
AS REQUIRED
PHARMA CY
AR
AR
AS REQUIRED
DIETETIC SERVICE
AR
AR
AR
20/BED
DINING AREA
2/BED
CANTEEN, RETAIL SALES
1/BED
VENDING MACHINE
(450 max./facility)
25/FIXTURE
RESIDENTS TOILETS
CHILD DAYCARE
AR
AS REQUIRED
AR
140
MEDICAL SUPPORT (Each)
140
140
STAFF OFFICES (Each)
120
EXAM / TREATMENT (Each)
120
FAMILY COUNSELING (Each)
120
10-0388-3
VA FORM
Page 1 of 4
MAR 2005

ADVERTISEMENT

00 votes

Related Articles

5 Things You Need To Know About The Gi Bill Benefits
Top 20 Happy Easter Cards And Gift Tags To Download For Free
Top Ten Easter Arts And Crafts Activities For Your Kids

Related forms

Va Form 10-0388-4 - State Home Construction Grant Programadult Day Health Care Va Form 10-0388-4 - State Home Construction Grant Programadult Day Health Care Legal
Va Form 10-0388-13 - Documents And Information Required For State Home Construction And Acquisition Grants - Post-grant Requirements Va Form 10-0388-13 - Documents And Information Required For State Home Construction And Acquisition Grants - Post-grant Requirements Legal
Va Form 10-0388-10 - Certification Of Compliance With Federal Requirements State Home Construction Grant Va Form 10-0388-10 - Certification Of Compliance With Federal Requirements State Home Construction Grant Legal
Va Form 10-0388-5 - Additional Documents And Information Required For State Home Construction And Acquisition Grants Application Va Form 10-0388-5 - Additional Documents And Information Required For State Home Construction And Acquisition Grants Application Legal
Va Form 10-0388-14 - Checklist Of Major Requirements For State Home Construction/acquisition Grants Va Form 10-0388-14 - Checklist Of Major Requirements For State Home Construction/acquisition Grants Legal
Va Form 10-0388-1 - Documents And Information Required For State Home Construction And Acquisition Grants Initial Application Va Form 10-0388-1 - Documents And Information Required For State Home Construction And Acquisition Grants Initial Application Legal
Va Form 10-0388-11 - Memorandum Of Agreement For A Grant To Construct Or Acquire A State Veterans Home Va Form 10-0388-11 - Memorandum Of Agreement For A Grant To Construct Or Acquire A State Veterans Home Legal
Va Form 40-0895-3 - State Or Tribal Government Cemetery Grants Service Space Program Analysis - Buildings Va Form 40-0895-3 - State Or Tribal Government Cemetery Grants Service Space Program Analysis - Buildings Legal
Va Form 10-0388-6 - Certification Of State Matching Funds To Qualify For Group 1 On The Priority List Va Form 10-0388-6 - Certification Of State Matching Funds To Qualify For Group 1 On The Priority List Legal
Va Form 10-0388-12 - Certification Regarding Debarment, Suspension, Ineligibility And Voluntary Exclusion - Lower Tier Covered Transactions Va Form 10-0388-12 - Certification Regarding Debarment, Suspension, Ineligibility And Voluntary Exclusion - Lower Tier Covered Transactions Legal

Related Categories

Parent category: Legal
Download
Go
Page of 4