Adult day care licensing requirements
[DOC File]The Agency For Health Care Administration
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Complete and submit sections 1, 2 and 8 of the Health Care Licensing Application, Adult Day Care, AHCA Form 3180-1004. Adult Day Care Center Local Zoning Form, AHCA Form 3180-1021. A satisfactory fire safety inspection authorizing the increase in capacity. $25.00 fee for replacement license/reissue of license due to change during licensure period.
[DOCX File]Health Care Licensing Application
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Health Care Licensing Application. Adult Day Care Center. The Agency for Health Care Administration (AHCA) has implemented the . ONLINE LICENSING SYSTEM. which. allows the electronic submission of renewal and change during licensure applications and fees, along with the ability to upload supporting documentation. To submit online please go to:
[DOC File]Chapter 388-97 WAC: Nursing Home Licensing regulations
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388-97-1880 Short-term care, including respite services and adult day or night care. 68. 388-97-1900 Dialysis services. 69. 388-97-1920 Preadmission screening — Level I. 70. 388-97-1940 Advanced categorical determinations, not subject to preadmission screening — Level II. 71. 388-97-1960 Preadmission screening — Level II. 71
[DOC File]Chapter 388-78A WAC: Boarding Home Licensing regulations
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If a person intends to convert a licensed nursing home building into a licensed boarding home, the building must meet all boarding home licensing requirements specified in this chapter and chapter 18.20 RCW unless the licensee has a contract with the department to provide enhanced adult residential care services in the boarding home per RCW 18 ...
[DOC File]Licensed capacity of the AFH Information Sheet
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Review Chapter 388-76 WAC for current licensing requirements. ... See WAC 388-76-10030. The department will only issue an adult family home license for more than one resident but not more than six residents. ... The number of people for which your home provides adult day care.
[DOC File]Assisted Living Application for Licensure
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I further affirm that I understand that I am eligible for a license only if the facility is in compliance with the law and regulations thereunder, and that the Office of Long Term Care is empowered to deny, suspend, or revoke my license on any of the grounds listed in the State Licensing Law.
[DOCX File]Adult Day Care Center - New Provider Certification ...
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Adult day care (ADC) centers serving publicly funded clients must meet state certification requirements in order to receive funds for the cost of care for these participants. Failure to complete this form completely and accurately may result in a delay in processing and/or denial of certification.
[DOCX File]Adult Day Care Center - Applicant Compliance Statement, F ...
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(See DQA form F-60947, Adult Day Care Certification Standards Checklist.) Disclaimer: The statements in this document paraphrase the Adult Day Care Certification Standards. This list should not be considered all-inclusive. The applicant is responsible for knowing and meeting all requirements.
[DOCX File]Minnesota.gov Portal / mn.gov // Minnesota's State Portal
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REQUIREMENTS FOR USE OF THIS SAMPLE DOCUMENT: Adult Day Services license holders are responsible for modifying this sample for use in their program. At a minimum, you must fill in the blanks on this form. You may modify the format and content to meet standards used by your program.
[DOC File]CHAPTER 59A-35
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(q) Adult Day Care Centers, as provided under Chapter 429, Part III, F.S.; AHCA Form 3180-1004, Rev. July 2009. (r) Clinical Laboratories, as provided under Chapter 483, Part I, F.S.; AHCA Form 3170-2004 (renewal), B (initial) or C (change of ownership), Rev. July 2009 or AHCA Form 3170-2004D, September 2009 (addition of specialty, or ...
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