Written Notice of Action.

(1)

A description of the action proposed.

(2)

The basis of the action.

(3)

The date of the notice of action.

(4)

The effective date of the action.

(5)

The law, regulation, or policy supporting the action.

(6)

The business address, phone number and name of the program director of the CCS agency taking the action.

(7)

Information explaining the applicant's or client's right of appeal, the right to request continuation of services during appeal, the right to review the medical record, the right to appoint a representative, how to initiate an appeal, appeal deadlines, and the address of where to obtain detailed information and assistance on the process.