309-040-0315 License Application and Fees (1) A completed, written application must be submitted by the applicant in a form and manner required by the Division along with the required $20 per bed non-refundable fee. The application is not complete until all information is received by the Division. (2) Incomplete initial applications are void after 60 calendar days from the date the Division receives the application and non-refundable fee. The Division will deny the incomplete application if not withdrawn. (3) An applicant must submit a separate complete application packet for each location operated as an AFH (Adult Foster Home) (4) The application must include the following: (a) The location of the AFH; (b) A brief description of the physical characteristics of the home; (c) The name, address, telephone number, and email address of the provider; (d) The distinct name of the AFH; (e) The maximum capacity requested and a written statement describing family members needing care, residents who receive respite care, persons who receive day care, or residents who receive room and board only; (f) A written statement from a physician, nurse practitioner, or physician assistant regarding the mental and physical ability of the applicant to provide care and services to residents and to operate the AFH. If the applicant employs a resident manager, the applicant must provide a written statement from a physician, nurse practitioner, or physician assistant regarding the mental and physical ability of the resident manager to provide personal care and services to residents and to operate the AFH; (g) A completed financial information form provided demonstrating to the Division the applicant’s financial ability and resources necessary to operate the AFH. Financial ability must include, but is not limited to, providing the Division with a current credit report, list of unsatisfied judgments, pending litigation, and unpaid taxes and notifying the Division regarding whether the applicant is in bankruptcy. If the applicant is unable to demonstrate the financial ability and resources required, the Division may require the applicant to furnish a financial guarantee as a condition of initial licensure in accordance with ORS 443.735(3)(e); (h) A signed letter of acknowledgment from the Community Mental Health Program or designee for the applicant to be licensed to operate the AFH; (i) Proof of experience providing direct care and services to adults with mental illness; (j) Documentation of an approved check in accordance with OAR 943-007-0001 through 0501 for the provider, the resident manager, caregivers, volunteers, and other occupants 16 years of age or older, excluding residents and other persons as defined in ORS 443.735; (k) Written background information pertaining to any current or previous licensure or certification by a state agency, including those licenses or certificates granted to a business or person affiliated with the business, including: (A) Copies of all current licenses or certificates; (B) Disclosure of any adverse action taken or proposed on any current or previous license or certificate, and documentation showing the final disposition of any suspension, denial, revocation, or other disciplinary actions initiated on any current or previous license or certificate, including settlement agreements, where applicable; and (C) Documentation of any substantiated allegations of abuse or neglect pertaining to the applicant or anyone employed by or contracted with the applicant. (l) Verification of completion of all required trainings for the provider, resident manager if applicable, and all substitute caregivers including, but not limited to: (A) Division-approved AFH Provider Orientation; (B) Mandatory Abuse Reporting; (C) Current CPR and First Aid certification; (i) Accepted CPR and First Aid courses must be provided by or meet the standards of the American Heart Association or the American Red Cross. (ii) CPR or First Aid courses conducted online are only accepted by the Department when an in-person skills competency check is conducted by a qualified instructor meeting the standards of the American Heart Association, the American Red Cross. (m) Verification of home ownership or copy of current lease or rental agreement that includes; (A) The owner and landlord’s name; (B) Verification that the rent is a flat rate; and (C) Signatures of the landlord and applicant and the date signed. (n) A floor plan of the AFH containing the required components as outlined in OAR 309-040-0370(3). (o) One copy of written approved certificate of occupancy based on the change of use of the setting, issued by the city or county building codes authority having jurisdiction; (p) A completed AFH Self-Inspection related to HCBS compliance and Fire Safety, using division approved forms; (q) The AFH plan of operation, including: (A) The use of substitute caregivers and other staff; (B) A description of how the providers or substitute caregivers must be directly involved with residents daily. (C) How the providers and substitute caregivers will be prepared to communicate with all residents who live in the home including residents with limited English proficiency. (D) Detail how transportation and community engagement will occur. (r) Proposed policies and procedures regarding: (A) Staff training, (B) Service planning, medication administration, food preparation and distribution; and (C) Safety, emergency response, succession planning and facility closure. (D) Communication and services for persons with limited English proficiency. (5) The Division must determine compliance with these rules based on receipt of the completed application material and fees, a review and investigation of information submitted, an in-person inspection of the AFH, and interviews with the applicant and other individuals as determined necessary by the Division. (6) The applicant may withdraw the application at any time during the application process by notifying the Division in writing. (7) The Division may elect to deny an application when: (a) The applicant has previously had any adverse action taken on a certificate or license by the oversight body; or (b) Action taken on a certificate or license may include but is not limited to denial, suspension, conditions, intent to revoke, nonrenewal, or revocation by the Division, the Authority, the Oregon Department of Human Services, or any other state agency; (c) The applicant fails to provide accurate information; and (d) The applicant may appeal the denial of the application by submitting a request for reconsideration in writing to the Division within 14 calendar days from receipt of the denial notice. The Division must decide on the appeal within 30 days of receipt of the appeal. (8) An applicant whose license has been revoked or voluntarily surrendered, following a receipt of Notice of Intent to Revoke or Notice of Intent to Not Renew from the Division, or whose application has been denied by the Division for reasons relating to, but not limited to, criminal convictions, civil proceedings against the applicant, or substantiated allegations of abuse by the applicant, may not be permitted to submit an application for one year from the date that the revocation, non-renewal, surrender, or denial is made final. A longer period may be specified in the order revoking or denying the license. (9) The AFH must be in full compliance with all Home and Community Based required qualities of 42CFR §441.710(a)(1), OAR 410-173-0035, and OAR 411-004. (10) At or about 90 days after initial licensure, but no more than 120 days after an initial license is issued, the Division will inspect the AFH to ensure compliant operation. Statutory/Other Authority: ORS 413.042, ORS 443.420 & SB 739 (2025) Statutes/Other Implemented: ORS 443.705 - 443.825 History: BHS 26-2025, amend filed 12/23/2025, effective 01/01/2026 BHS 5-2025, amend filed 02/28/2025, effective 03/01/2025 BHS 6-2018, amend filed 03/21/2018, effective 03/30/2018 MHS 12-2017, temporary amend filed 10/03/2017, effective 10/03/2017 through 03/30/2018 MHS 9-2017, f. 6-29-17, cert. ef. 7-1-17 MHS 3-2017(Temp), f. 3-3-17, cert. ef. 3-4-17 thru 8-30-17 MHS 14-2016(Temp), f. 9-6-16, cert. ef. 9-7-16 thru 3-3-17 Renumbered from 309-040-0015, MHD 3-2005, f. & cert. ef. 4-1-05 MHD 6-1999, f. 8-24-99, cert. ef. 8-26-99 MHD 1-1992, f. & cert. ef. 1-7-92 (and corrected 1-31-92)