1.2 Adult Care Facility Types -...

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1.1 Overview

1.2 Adult Care Facility Types


1.3 Mission of the Community Care Licensing Division

1.4 Responsibility of Community Care Licensing Division


1.5 Prevention

1.6 Compliance


1.7 Enforcement

1.8 Application Process Overview


1.9 Application Orientation

1.10 Operations and Record Keeping Orientation


1.11 Face to Face Interview

1.12 Forms and Instructions


1.13 Certificate of Attendance

1.14 Adult and Senior Care Licensing Programs


1.15 Adult and Senior Care Licensing Offices

1.16 Adult and Senior Care Licensing Offices


1.17 Community Care Licensing Division

1.18 Inspection Authority


1.19 Who needs to be licensed?

1.20 When is a license required?


1.21 What is a Community Care Facility?

1.22 Adult Care Facility Clients and Residents


1.23 Elements of Care and Supervision

1.24 Elements of Care and Supervision, cont.


1.25 Unlicensed Facility Operation


2.1 Introduction

2.2 Adult Care Facility Types


2.3 Adult Residential Facilities (ARF)

2.4 Social Rehabilitation Facilities (SRF)


2.5 Residential Care Facilities for the Chronically Ill (RCFCI)

2.6 Adult Residential Facilities for Persons with Special Health Care Needs


2.7 Adult Day Programs (ADP)

2.8 Limits & Terms of a License


2.9 Sale of an Operating Adult Care Facility

2.10 Who is the licensee?


2.11 Licensee's Responsibility

2.12 Overconcentration


2.13 Conditional Use Permit

2.14 Fire Clearance


2.15 LIC 9092

2.16 Determining Ambulatory Status


2.17 Non‐Ambulatory Status

2.18 Bedridden Status


3.1 Personnel Requirements

3.2 Adult Care Personnel Requirements


3.3 Criminal Record Clearance Requirements

3.4 Criminal Record Exemptions


3.5 Administrator Qualifications and Responsibilities

3.6 Administrator Qualifications Adult Residential Care Facility


3.7 Administrator Qualifications Adult Day Program

3.8 Administrator Qualifications Social Rehabilitation Facility


3.9 Administrator Qualifications

3.10 Administrator Qualifications


4.1 Physical Plant Requirements

4.2 Physical Plant Requirements All Adult Residential Care Facilities



4.4 Physical Plant Requirements Adult Day Programs



4.6 Outdoor Activity Space


4.7 Food Service All Adult Residential Care Facilities except RCFCI

4.8 Food Service Residential Care Facilities for Chronically Ill (RCFCI)


4.9 Food Service Adult Day Programs


5.1 Completing the Application (Section A)

5.2 Completing the Application


5.3 Application Fees

5.4 Section A Documents


5.5 LIC 200

5.6 LIC 215


5.7 LIC 215 (Page Two)

5.8 LIC 308


5.9 LIC 309



5.11 LIC 400

5.12 LIC 402


5.13 LIC 401

5.14 LIC 401a


5.15 Balance Sheet and Balance Sheet Supplemental Schedule

5.16 LIC 403a


5.17 LIC 403a

5.18 LIC 403


5.19 LIC 404

5.20 LIC 500


5.21 LIC 500 (Page 2)

5.22 LIC 501



5.24 LIC 503


5.25 LIC 508



5.27 LIC 610D

5.28 LIC 999



5.30 LIC 9054


6.1 Completing the Application (Section B)

6.2 B6. Partnership Agreement and Articles of Incorporation


6.3 Partnership Applicants

6.4 Corporation Applicants


6.5 Out of State Corporation Applicants

6.6 Limited Liability Company Applicants (LLC)


6.7 Out of State Limited Liability Company Applicants (LLC)

6.8 B2. Verification of Administrator Qualifications


6.9 B3. Documentation is not required for this application

6.10 B4. Job Descriptions


6.11 B5. Personnel Policies and Hiring Practices

6.12 B5. Personnel Policies and Hiring Practices, cont.


6.13 B6. Required Training

6.14 B7. Facility Program Description


6.15 B7. Facility Program Description

6.16 B8. Discipline Policies


6.17 B9. Admission Policies Summary of Admission Policies

6.18 B9. Admission Policies Summary of Admission Policies


6.19 B9. Admission Agreement Contract with client

6.20 B9. Admission Agreement Contract with client


6.21 B10. Sample Menu

6.22 B16. Control of Property


6.23 B12. Bacteriological Analysis of Water

6.24 B13 and B14 Documentation is not required for this application


6.25 B15. Neighborhood Complaint Policy

6.26 B16. First Aid Card


6.27 B17. Orientation Certificates


7.1 Final Steps

7.2 Establish a Plan


7.3 Application Submission

7.4 Application Process


7.5 Application Denial

7.6 Congratulations

Date post:	11-Mar-2018
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