Facility Site Review
  • KSB Facility Site Review
  • General FSR Overview
  • 📃Conducting an FSR Audit
    • Conducting an Audit on the eTool
      • 1. Template 🎬
      • 2. Submission 🎬
      • 3. Notes/Communication Log 🎬
      • 4. FSR Face Sheet 🎬
      • 5. FSR Scoring Sections 🎬
      • 6. MRR Face Sheet 🎬
      • 7. Medical Records Reference 🎬
      • 8. MRR Scoring Sections 🎬
      • 9. CAP Tool
      • 10. Pending CAP Item List
      • 11. Staff Training Writer
      • 12. 1st CAP / Score Notification
      • 13. Issuing a CAP
      • 14. FSR/MRR Complete
    • Uploading an Audit to KSB
      • 1. Generate an Audit ID
      • 2. PHI-free MRR
      • 3. Uploading to KSB
      • 4. Upload Complete
  • Frequently Asked Questions
    • How do I Look Up Provider Information?
    • How do I Look Up Site Information?
    • How do I Look Up Audit Information?
    • How do I Generate Reports from KSB?
    • eTool - Frequently Asked Questions
  • Additional Information
    • Site Verification Form
    • Creating New Users
      • Creating Read-Only Users
    • JSON Audit Files
      • FSR JSON File
      • MRR JSON File
    • Looking Up Past Audits
    • Types of Review Documents
    • DHCS Documents
    • Additional Tabs on the eTool
      • Blank 1st CAP Notice
      • Appointment (Appt)
      • Final (Completion Notice)
    • View and Revise FSR/MRR Comments in the KSB Application
      • FSR Comments
      • MRR Comments
    • Generating Comments on the eTool
      • FSR Scoring Sections
      • MRR Scoring Sections
      • PARS Scoring Sections
    • Time Stamp Features
    • Reports
      • Corrective Action Plan (All Open CAPS)
      • KSB FSR Audit Tracker
      • MCP FSR Assignment (Macro-level)
      • MCP FSR Assignment (Micro-level)
      • FSR/MRR Average Scores by County
      • FSR/MRR Average Scores by State
      • Criteria Level Compliance
      • Criteria Level Compliance (Incl. Overall & Subsection Scores)
      • Completed Reviews (Recent vs. Previous Score Comparison)
    • Level 3 User Functions
      • Looking Up Sites/Providers
  • Resources
    • 🎬Video Resources
      • 🎬Providers
        • 🎬How to Create a Provider
        • 🎬How to Look Up Providers
      • 🎬Sites
        • 🎬How to Create a Site
        • 🎬How to View and Edit Sites
      • 🎬Audits
        • 🎬How to Create an Audit
        • 🎬How to Look Up Audits
      • 🎬How to Manage Site Providers
      • 🎬FSR eTool
        • 🎬FSR eTool: Template Tab
        • 🎬FSR eTool: Submission Tab
        • 🎬FSR eTool: Notes Tab
        • 🎬FSR eTool: FSR Face Sheet
        • 🎬FSR eTool: FSR Scoring Sections
        • 🎬FSR eTool: MRR Portion
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  1. Additional Information
  2. Additional Tabs on the eTool

Blank 1st CAP Notice

PreviousAdditional Tabs on the eToolNextAppointment (Appt)

Last updated 2 years ago

The Blank 1st CAP Notice tool can be useful to the reviewer when conducting an audit. This notice is a backup, to be printed as a hard copy and brought to the site. If there are any issues with issuing a 1st CAP Notice via pdf or email, or by accessing the clinic's printer system, having this hard copy may be handy.

The reviewer will manually fill the information out on this 1st CAP form based on the information entered in the FSR/MRR.