citations on the AFH Incident Log

Adult Family Home Providers are receiving needless citations on the AFH Incident Log. I’m going to explain the difference between the Incident Log and an Incident Report, and what you need to know about that WAC so you don’t get cited. I’ll also share how I’ve used a detailed Incident Report form to help me deal with a very difficult family member.

Being a seasoned geriatric nurse, I tend to keep more detailed records. So a number of years ago, I “upgraded” the bare-bones State-provided Incident Log form into a more detailed 1-page “incident report” form that I completed and used in each resident’s chart following an incident.

I was proud of it! In that 1-page incident report, I documented details about each incident for that particular resident and kept it in that resident’s chart. 

But… I ran into an issue when I got audited.

Although a more complete incident report is helpful in tracking the specifics of an incident and a good documentation practice, it’s NOT part of what the “Incident LOG” requirement is.

The Incident Log requirement in WAC 388-76-10220 is to track incident trends in general for ALL residents in your AFH. It doesn’t require much detail, only the essentials of WHO, WHAT, WHEN, and OUTCOME. This is to spot problematic trends, i.e., various residents suffering falls in the AFH, as well as suspected abuse, neglect, exploitation, etc.

Bottom line recap

The AFH Incident LOG – WAC 388-76-10220 

  • Required, similar to the AFH Fire Drill log (in fact, you might keep them in the same binder). 
  • Keep in your AFH Admin records; not needed in the Resident’s record
  • Used to spot overall trends in the AFH. 
  • Part of your AFH’s legal record
  • No need to have a lot of specifics 
  • Keep ONE form for all incidents in the AFH

Detailed Incident REPORT

  • NOT required as part of 388-76-10220
  • A good way to track and document the details and specifics of a resident who suffers an incident
  • Can be kept in the actual resident’s record
  • Not necessarily audited as part of the “Incident Log” requirement
  • Could be audited as part of the resident’s record, to make sure everything is documented appropriately. 

Another way to use your Incident Report form

Three years ago, I had a super-tough family member who caused a lot of “incidents” in my AFH, and I used my form to document all of them. When it came time to end the nonsense, it made a huge difference in showing her flagrant bad faith and willful negative interference in my AFH. I kept these reports in my own self-audit file, which is not subject to being audited, but that you can use to document and keep certain records such as this.

Get Joseph’s custom “AFH Incident Report” form – FREE!*

Get the “AFH Incident Report” form

Hope this helps. Feel free to leave your questions below.

*NOTICE. This form is Copyrighted. You must retain the Copyright Notice or credit in all versions and derivatives of the this material. If you want to use this template without a credit, you must obtain written permission from the author.

Joseph Spada
Joseph Spada

Adult Family Home Consultant, geriatric nurse, owner of Spada Care Homes, Ohana Hale Senior Living, and Savanna Healthcare; DSHS instructor of the AFH Administrator Training; speaker; author.

    12 replies to "Citations on the AFH Incident Log"

    • Mailyn franada

      Hello Joseph I’m new provider can pls give me all the paperwork needs inresident chart ,like personal belongings,assessment, negotiated care plan,

      • Joseph Spada

        Hello Mailyn. There is A LOT of paperwork needed to meet compliance. Setting up your documentation system involves creating charts for residents, staff, and administration, and having your policies and procedures in place, including various forms and a solid residency agreement to protect yourself and your business. It’s very involved, and it would not be much help for me to give you a long random list of forms without understanding exactly where you’re at and what else you need.

        As an AFH consultant of 33 years, I can help you from start-up to success. The first step is to a brief phone meeting to evaluate where you are now and clarify what else you may need to get set up the right way from the start, and not waste time or money on things you don’t need. I will reach out by email.

    • Dr. Roy Sykes

      Excellent class, valuable information. Mr. Spada is a knowledgeable and skilled instructor.

      Roy L. Sykes ThD, MS
      Sean Humphrey House

    • Edwina

      Hi Joseph, I don’t have a website and I can’t get through to download a copy of an Incident report form, do I need to have a website? first timer in your site and found it interesting. You have a good heart to share what you know, hoping for you to gain more knowledge to share, HE is watching you God Bless!

      • Joseph Spada

        You do NOT need a website, just a valid email address. When you fill out the form, you get an email with a link to download the file to your computer. The system you registered successfully and received an email with the link… look for that email in your inbox or SPAM folder.

    • Julianne


      For what incidents are we to call the hotline? And are those all residents or just DSHS/Medicaid residents?


      • Joseph Spada

        Julianne; Generally, issues related to abuse, neglect, missing residents, evacuation, etc., apply to both private and DSHS. For Medicaid/DSHS residents, also report to DSHS when there is a change in condition, a death, illness that requires hospitalization, etc. Specific reporting details can be found here: 388-76-10225 and 388-76-10673.

    • sonam

      Thank you for putting this post.
      I had a question regarding a fall. Do we have to call the state for fall. Or just notifying the family and doctor is enough?

    • sonam

      Thank you for putting this post.
      I had a question regarding a fall. Do we have to call the state for fall. Or just notifying the family and doctor?

      • Joseph Spada

        Hi Sonam. If the resident is a DSHS/Medicaid resident, then you should inform the DSHS case worker, and the POA/family of the fall. If the resident is private pay, you should report to the POA/family, and 911 if you suspect that the resident could be injured.

        Depending on why the fall occurred, you and the case worker may want to review, or revise the plan of care to lower the risk of falls. If that involves more work on your part, the rate level might need revision as well.

        Otherwise, for your DSHS residents, you need report when there is a significant change in the resident’s condition, a serious injury, trauma, death of a resident, an outbreak of suspected food poisoning, or communicable disease.

        • Mailyn Franada

          Hello I’m a new provider and trying to organize my res chart can tell me what suppose to include in my res chart like personal belongings,assessment, negotiated care plan

          • Joseph Spada

            There is a lot that goes into organizing your AFH documentation systems to be compliant and make sure you have everything required; Staff files, residents files, AFH administration binder, infection control, Policies, and more. If you need help please reach out to me with a request for support, or look for a competent consultant.

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