Arizona Administrative Code › Title 21 - CHILD SAFETY › Chapter 7 - DEPARTMENT OF CHILD SAFETY - CHILD WELFARE AGENCY LICENSING › Article 1 - LICENSING REQUIREMENTS FOR A CHILD WELFARE AGENCY › Section R21-7-108 - License Renewal Requirements

Current through Register Vol. 30, No. 28, July 12, 2024
A. No earlier than 90 calendar days and no
				later than 60 calendar days prior to the expiration date of a license, an
				Agency may apply for renewal of its license and any operating
				certificate.
B. The Department may
				treat an Agency's failure to apply timely for renewal as a voluntary closure
				under R21-7-117.
C. The Agency shall submit a complete renewal
				application on a form provided by the Department.
D. With a renewal application, the Agency
				shall also submit the following documentation:
1. Evidence of financial stability in
				compliance with
				R21-7-104;
2. A certificate of current insurance
				coverage as prescribed in
				R21-7-128;
3. Evidence of a passing physical site and
				environmental reports:
a. Fire inspection
				report from the state fire marshal or local fire department inspector for each
				facility when required by the local jurisdiction;
b. Any other inspection certificates,
				inspection reports, or building occupancy certificates required by the local
				jurisdiction; and
c. Gas equipment
				inspection report for applicants under Article 2 of this Chapter.
4. Agency identification of and
				the following background information for the Agency, facility, and
				administrators:
a. Name, address, and
				telephone; email for the Agency and each facility operated by the
				Agency;
b. Name, title, business
				address, and telephone number of:
i. The CEO
				for the Agency described in
				R21-7-131;
ii. Program Director role as prescribed in
				R21-7-131;
iii. The person with delegated authority to
				act when the CEO is absent;
iv. The
				supervisor in charge of each separate facility;
v. Any person holding ownership interest in
				the Agency; and
vi. Agency and
				facility medical directors, if applicable;
c. A list of the members of the Agency's
				governing body if applicable, described in
				R21-7-118;
d. Any changes in licenses or certificates by
				the applicant or any person listed in subsection (D)(4)(b);
e. A written description of any proceedings
				for denial, suspension, or revocation of a license or certificate for provision
				of medical, psychological, behavioral health, or social services, pending or
				filed, or brought against the applicant or a person listed in subsection
				(D)(4)(b), including those held in this state or another state or country;
				and
f. A written disclosure of any
				new or previously unreported civil and criminal court proceedings as outlines
				in R21-7-107(B)(1)(g)
				in which the applicant or a person listed in subsection (D)(4)(b) has been a
				party, including outcomes or updates to previously reported civil or criminal
				litigation;
5. An
				organizational chart for the Agency and each separate facility, showing
				administrative structure, lines of authority, and staff;
6. A list of all applicant's staff on a form
				provided by the Department;
7. For
				any staff whose primary residence is at the facility, the information outlined
				in R21-7-107(B)(4);
8. An annual written report evaluating the
				Agency's achievement of the goals and objectives described in its
				application;
9. Copies of all
				written complaints the Agency has received about its performance at any
				facility and the Agency's response to the complaints. This does not include any
				licensing complaints investigated by the Department during the expiring
				licensing year;
10. A written
				description of any changes in program services or the children served by the
				Agency; and
11. A current list of
				contracts related to the Child Welfare Agency license.