Agency Schedule Detail

Authorization Number : 14400469

Agency Series No. : 11-04

Status : Active

Agency Web Link :

Agency : DOH

Confidential Description : Includes medical information.

Division :

Vital Description : Only record of Investigation.

Section :

Record Title : Complaint Files

Revision : 0

Record Description : Includes, but not limited to, Complaint Intake Form (HEA 1681), Report of Investigation of Complaint (HEA 1602), ODH Complaint QA Form, and various correspondence and supporting documentation. May contain confidential complaint or patient information.

Retention Period	Retention Justification	Media Code	Method of Disposal
Retain for a total of 5 years; three in office then forward to approved records storage center for additional two years.	State Operations Manual.	Paper	Shred

Approvals

Status	Name	Title	Date
Approved	Jill Harris	Records Coordinator	3/13/2002 10:27:00 AM
Approved	Margaret Buckholz	Records Officer	3/13/2002 10:29:00 AM
Approved	Michael Hardenbrook	Record Administrator	3/14/2002 2:07:00 PM
Approved	Martin Meeks	State Auditor	3/19/2002 3:44:00 PM
Approved	Charles Arp	State Archivist	3/19/2002 3:44:00 PM

Notes

Date	Reason	User