Updated Notice of Transfer or Discharge form available for Adult Family Homes, Enhanced Services Facilities and Assisted Living Facilities

Washington Department of Social and Health Services – Home and Community Living Administration sent this bulletin at 12/24/2025 01:11 PM PST

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December 24, 2025

Notice of Transfer or Discharge form available

This message is to let you know that Residential Care Services has updated the optional form, Notice of Transfer or Discharge (DSHS 15-458) for Adult Family Homes, Assisted Living Facilities and Enhanced Services Facilities. The Word form is now posted on the Electronic DSHS Forms page.

The PDF version of the form is not yet available. If you prefer the PDF version, please check for the new form in January 2026.  

How to get the form

This optional form can be used beginning Jan. 1, 2026.

There are two ways to get form 15-458: 

  1. Download form 15-458 (in Word).
  2. Electronic DSHS Forms page. Type 15-458 in the Form Number field.
  3. If you prefer a PDF version of the form, please choose the 2025 PDF file as follows: on the Electronic DSHS Forms page, type in the form number and select “Adobe PDF,” which should be the 2025 version. This looks the same as the Word version. 

For more information about the rules

For more information about Home and Community Based Settings rules effective Jan. 1, 2026, please go to the following links: