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)
• Refrigerator and Freezer Temperature Log
  

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
  
• WIC Fact Sheet 
  

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