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Residential Care Home Uniform Disclosure Form

Wednesday, March 26, 2025 - 12:00

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Residential_Care_Home_Uniform_Disclosure_Form.pdf (912.6 KB)

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Form RCH Residential Care Home

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Division of Licensing and Protection
HC 2 South, 280 State Drive
Waterbury, VT 05671-2060
(802) 241-0344

For Telecommunications Relay Service: Dial 711

Adult Protective Services Reporting Line
(800) 564-1612

Healthcare Organization Complaint Reporting Line
(888) 700-5330

Joe Nusbaum
Division Director

John Gordon
Adult Protective Services Director

Pamela Cota
Survey and Certification Director

This is a Division of the
Department of Disabilities, Aging and Independent Living
under the Agency of Human Services

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