Quality Facility Site Review Resources

Section 1 - Facility Site Review Overview

• DHCS Policy Letter

Section 2 - Facility Site Review Forms

• Authorization to Release Healthcare Information (DHCS Form)
• Health Education Programs
  
• Language Assistance Program Requirements
  
• Refrigerator and Freezer Temperature Log
• Facility Site Review Tool for Audits

Section 3 - Medical Record Review Forms

• Bright Futures Pediatric Periodicity Schedule
• CDC Adult BMI Resources
• CDC Adult Immunization Schedule (19+ Years of Age)
• CDC Children and Adolescent BMI Tables
• CDC Growth Charts
• CDC Pediatric Immunization Schedule (0-18 Years of Age)
• County of San Diego Behavioral Health Resources
  
• DHCS Stay Health Assessment Resources and Forms
• Industry Collaboration Effort Interpreter Quality Standards Guidance
  
• Industry Collaboration Effort Language Proficiency Assessment Resources
• WIC Fact Sheet 
• Medical Record Review Tool for Audits

Section 4 - Physical Accessibility Review Survey Regulations

• DHCS PL 12-006 
• Physical Accessibility Review Survey

Section 5 - Facility Site Review Training Resources

• Training Slides for New Facility Site Review Tools and Guidelines

If you need additional resources or have questions, please email the California Community Plan Quality Department at uhcquality@uhc.com.