All information requested must be supplied in order to have your application for a variance or waiver considered. If you require additional space to explain your request, you may attach a continuation sheet. However, it could be an attorney or someone else designated by the license holder to provide information on behalf of the licensed facility concerning the variance or waiver request. List each rule separately for which a variance or waiver is being requested. Determine whether you are seeking a variance or waiver and check accordingly.
Most requests are for variances.
A variance is a request to permit some departure or variation from the literal requirements of the rule, e.g. the rule requires a 6-foot wide hall and your hall is 70 inches wide. Explain how complying with the rule would cause you a substantial hardship and any other information you believe justifies your application. List the alternative standards or conditions you are willing to meet which relate to the underlying purpose of the rule for which a variance or waiver is being requested. Explain how the standards or conditions listed in Section 5. will provide adequate protection for the health, safety and welfare of the person receiving care through your licensed facility or program. Explain why you believe the variance or waiver would serve the purpose of the underlying statute.