CE Tracking Sheet
Professional CE Tracking Sheet template for Adult Family Homes. Includes editable Word (.docx) and printable PDF formats.
[YOUR ADULT FAMILY HOME NAME HERE]
CE Tracking Sheet
TEMPLATE • Inspection-Ready AFH Standard
1. Annual 12-Hour CEU Requirement Overview
This agreement is entered into on this _____ day of ____________, 20___, between [ADULT FAMILY HOME NAME] (Provider) and [RESIDENT / POA NAME].
2. Course Title, Provider & Hours Completed Log
FINANCIAL TERMSBase Rate & Payment Schedule: Resident agrees to pay Provider a monthly base fee of $______ payable in advance on the first (1st) day of each calendar month.
3. Certificate Storage Verification Checkbox
Provider Signature / Date
Resident / POA Signature / Date
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Document Section Breakdown (4 Sections)
Annual 12-Hour CEU Requirement Overview
DSHS / licensing continuing education requirements and annual deadline tracker.
Course Title, Provider & Hours Completed Log
Date, course topic, training organization, instructor, and hours earned table.
Certificate Storage Verification Checkbox
Verification check for physical certificate in employee personnel file.
Annual CEU Compliance Provider Sign-Off
Provider annual review and approval signature verifying staff compliance.
Or get this form included in the Operations & Records Bundle ($69)