California Code of Regulations › Title 22 - Social Security › Division 6 - Licensing of Community Care Facilities › Chapter 8 - Residential Care Facilities for the Elderly (RCFE) › Article 3 - Application Procedures › Section 87155 - Application for License

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) Any
				  individual, firm, partnership, association, corporation or governmental entity
				  desiring to obtain a license shall file with the licensing agency an
				  application on forms furnished by the licensing agency. The licensee shall
				  cooperate with the licensing agency in providing verification and/or
				  documentation as requested by the licensing agency. The application and
				  supporting documents shall contain the following:
(1) Name or proposed name and address of
				  facility.
(2) Name and address of
				  the applicant and documentation verifying completion by the applicant of
				  certification requirements as specified in Section
				  87406, Administrator Certification
				  Requirements.
(A) This section shall apply to
				  all applications for license, unless the applicant has a current license for
				  another residential care facility for the elderly which was initially licensed
				  prior to July 1, 1989, or has successfully completed an approved certification
				  program within the prior five years.
(B) If the applicant is a firm, partnership,
				  association, or corporation, the chief executive officer or person serving in a
				  like capacity or the designated administrator of the facility shall meet the
				  requirements of this section.
(3) If the applicant is a partnership, the
				  name, signature and principal business address of each partner.
(4) If the applicant is a corporation or
				  association, the name, title and principal business address of each officer,
				  executive director, and member of the governing board. The application shall be
				  signed by the chief executive officer or authorized representative. In
				  addition, a copy of the Articles of Incorporation, Constitution and By-laws,
				  and the name and address of each person owning more than 10 percent of stock in
				  the corporation shall be provided.
(5) If the applicant is a corporation, each
				  member of the board of directors, executive director, and any officer shall
				  list the name of all facilities which they have been licensed to operate,
				  employed by or a member of the board of the directors, executive director or an
				  officer.
(6) Procedures as required
				  pursuant to Section
				  1569.175
				  of the Health and Safety Code.
(7)
				  Name and address of owner of facility premises if applicant is leasing or
				  renting.
(8) The category of
				  facility to be operated.
(9)
				  Maximum number to be served.
(10)
				  The name, residence and mailing addresses of the facility administrator, a
				  description of the administrator's background and qualifications, and
				  documentation verifying the required education and administrator
				  certification.
(11) Copy of the
				  current organizational chart showing type and number of positions and line of
				  authority. However, facilities for less than sixteen persons may furnish, in
				  lieu of an organization chart, a list of positions and the periods of time that
				  persons in these positions will be providing services at the
				  facility.
(12) Evidence pursuant to
				  Health and Safety Code, section
				  1520(b).
(13) A financial plan of operation on forms
				  provided or approved by the Department. Start-up funds shall be sufficient to
				  meet a minimum of three (3) months operating costs. In addition:
(A) Where construction is anticipated to meet
				  the requirements for a license, sufficient financing for the construction shall
				  be available.
(B) The scope of the
				  applicant's services shall be such that an adequate quality of service will be
				  permitted from available funds. The licensing agency shall have the right to
				  verify the availability of these funds.
(14) When there is a change of licensee, the
				  required documentation shall include the information specified in Section
				  87217(k).
(15) Information concerning insurance carried
				  by the applicant relating to the operation of the facility.
(16) A plan of Operation as specified in
				  Section 87208, Plan of
				  Operation.
(17) The fee for
				  processing the application for the requested capacity as specified in Section
				  87156, Licensing Fees.
(18) Name, address and telephone number of
				  the city or county fire department, the district providing fire protection
				  services, or the State Fire Marshal's Office having jurisdiction in the area
				  where the facility is located.
(19)
				  Such other information as may be required by the licensing agency for the
				  proper administration and enforcement of the licensing law and
				  regulations.