AGENCY: Department of Health and Human Services. Division of Substance Use and Mental Health. State Hospital

SERIES: 82180
TITLE: Safety Check Sheet
DATES: 1987-
ARRANGEMENT: Chronological.

DESCRIPTION: This record is generated daily and shows the status of each patient on the unit. This form is used to track 15 minute checks conducted on every patient through the 24 hour period. The record includes patient names, hospital number, status, leave, etc.

RETENTION

Retain for 2 month(s) after completion of publication or report

DISPOSITION

Destroy.

RETENTION AND DISPOSITION AUTHORIZATION

Retention and disposition for this series is authorized by Archives general schedule Transitory tracking records, GRS-1720

AUTHORIZED: 02/11/2021

FORMAT MANAGEMENT

Paper: Retain in Office for 2 months after date of report and then destroy.

APPRAISAL

Administrative Fiscal

This record is required by the Joint Commission of Accredited Hospitals (JCAH).

PRIMARY DESIGNATION

Controlled. Utah Code 63G-2-304(2008)

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