Pennsylvania home care license application

    • [PDF File]APPLICATION FOR LICENSE

      https://info.5y1.org/pennsylvania-home-care-license-application_1_9c2f0f.html

      APPLICATION FOR LICENSE ... STATE GOVERNMENT COUNTY GOVERNMENT OTHER NURSING HOME BASED 11. PRIOR TO LICENSE STATUS Has the facility (Item 1) for Legal Entity (Item 2), or the Person Responsible (Operator) (Item 5), or the person signing the application ... of the Commonwealth of Pennsylvania and with the rules and regulations of the Department ...

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    • [PDF File]Pennsylvania Application for Subsidized Child Care

      https://info.5y1.org/pennsylvania-home-care-license-application_1_78e444.html

      Pennsylvania Application for Subsidized Child Care If you want help in paying your child care costs, you must complete this application. This is an application for subsidized child care. This application is also available in Spanish. If you need help with reading and/or completing this application, please contact your local ELRC agency.

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    • [PDF File]APPLICATION FOR ASSISTED LIVING RESIDENCE LICENSE

      https://info.5y1.org/pennsylvania-home-care-license-application_1_618e4a.html

      Commonwealth of Pennsylvania TYPE OF APPLICATION (check all that apply) Initial Application : Renewal Application License # _____ Change in Capacity . Change in Ownership . Add Special Care Unit Designation . ... Standard Assisted Living License with Special Care Unit Designation . Is residence already licensed as a Personal Care Home? Yes . No .

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    • [PDF File]Reactivation Checklist - Pennsylvania Department of State

      https://info.5y1.org/pennsylvania-home-care-license-application_1_637400.html

      , I have practiced as a nursing home administrator in Pennsylvania after my license expired and I want to reactivate my license at this time by paying the biennial renewal feeof $297.00 and applicable late renewal fees ($5.00 per month or part of the month after the expiration date).

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    • [PDF File]State Licensure Application Process

      https://info.5y1.org/pennsylvania-home-care-license-application_1_08511f.html

      State Licensure Application Process Step 1: Complete and submit an application packet for administrative review • To begin the application process, you must first submit a completed application packet for a license to operate an agency/facility in Pennsylvania.

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    • [PDF File]If you fail to submit all requested information, the ...

      https://info.5y1.org/pennsylvania-home-care-license-application_1_e0a3e1.html

      Care Agency/Home Care Registry. Please note that all questions must be answered, and all requested supporting documentation must be provided. If you fail to submit all requested information, the application materials will be mailed back to you. If your application is in accordance with Pennsylvania Home Care Agency rules

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    • [PDF File]APPLICATION FOR CERTIFICATE OF COMPLIANCE - …

      https://info.5y1.org/pennsylvania-home-care-license-application_1_f11f45.html

      personsigning the application ever been denied a Certiicate or license, had a Certiicate of Complianceor ... (Any false information or statement knowingly given in this application is punishable under Section 4904 of the Pennsylvania Crimes Code.) ... Foster Family Care Agency Services, Group Day Care Home, Mobile Programs, Non-Secure ...

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    • [PDF File]State Name Q1: How are private duty agencies licensed? Q2 ...

      https://info.5y1.org/pennsylvania-home-care-license-application_1_8068e6.html

      a home care license but licensure will exist for these agencies… We anticipate some 750 Companion Sitter (non hands on care) ... Pennsylvania Eric S. Kiehl Private duty agencies and private duty registries will be licensed under the PA Dept. of Health by the end of this month.

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    • [PDF File]APPLICATION FOR APPROVAL OF ADMINISTRATOR-IN …

      https://info.5y1.org/pennsylvania-home-care-license-application_1_b7c282.html

      APPLICATION FOR APPROVAL OF ADMINISTRATOR-IN -TRAINING PROGRAM ... It is the responsibility of the applicant to locate a nursing home administrator and a nursing home that is willing to provide training in an Administrator -In-Training Program. ... Pennsylvania Bureau …

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