7 AAC 75.080 - Application for license; modification
(a) A person may
not begin operation of an assisted living home until that person has obtained a
probationary or standard license from the department. A person may not move the
location or make a major modification of a licensed assisted living home, or
increase the number of residents the home is licensed to serve until that
person has obtained approval for a modification of its license from the
department. An application under this section must be made on a form supplied
by the department. A person may not apply for a license to operate one or more
additional homes until each current home has passed the probationary period and
been issued a standard license. For purposes of this subsection, "major
modification" means a change to the home that, during construction of the
modification, would adversely affect the residents, services to the residents,
or emergency evacuation of the residents.
(b) An application for a license to operate
an assisted living home must be notarized and must contain
(1) the name, title, address, telephone
number, and, if available, electronic mail address and facsimile number of
(A) the applicant;
(B) each person who has an ownership interest
in the home;
(C) the chief
executive officer of the unit or subunit of government, if the applicant is a
government entity;
(D) the owner of
the premises in which the home will be located, if the applicant is not the
owner of the premises; and
(E) the
administrator of the home;
(2) the name of the assisted living home, if
known by a name;
(3) the address of
the assisted living home or the proposed new location of the assisted living
home;
(4) evidence that the
administrator meets the requirements of
7
AAC 75.215,
7
AAC 75.220, and
7
AAC 75.230;
(5) repealed 4/6/2002;
(6) the number of individuals within the
maximum occupancy number established by the fire safety inspection required
under 7 AAC 10.1010 that a home intends
to serve;
(7) the number of
residents the home intends to serve who are expected to be persons who
(A) have a primary diagnosis of mental
illness or physical or developmental disability; or
(B) are elderly or suffering from dementia,
but who are not mentally ill;
(8) the services the home proposes to
offer;
(9) copies of all permits
and approvals required by state or local government agencies, other than the
department, for construction or operation of the home;
(10) any request for a general variance from
a provision of AS 47.32,
7
AAC 10.1000 -
7
AAC 10.1095, or this chapter, as provided in
7
AAC 10.9500 -
7
AAC 10.9535 and
7
AAC 75.405;
(11) a staff plan that describes the number
of employees that will be employed by the home and each employee's
responsibilities; the application must indicate that the home is prepared to
modify the proposed staff plan to meet the terms of an individual residential
services contract executed under
AS
47.33.210 or an assisted living plan prepared
under AS
47.33.220 and
47.33.230;
(12) a disaster preparedness and emergency
evacuation plan that complies with
7
AAC 10.1010 to protect the residents of the home from
a disaster or other emergency;
(13)
a business plan, if applying to operate a home licensed for 11 or more
residents or to operate multiple homes; the plan must include a description of
the plan, services offered, the location of the business, a management and
personnel plan, and projected detail of anticipated monthly expenses for six
months; and
(14) information
concerning any denial of a prior application, voluntary termination of a
license during an investigation, or termination of an administrator or care
provider for cause.
(c)
An application to modify a license must contain the applicant's name, title,
address, telephone number, and, if available, electronic mail address and
facsimile number. The application must also describe the modification sought.
If the modification is to increase the number of residents served to 11 or
more, the application must also include the business plan described in (b)(13)
of this section.
Notes
Authority:AS 47.32.010
AS 47.32.030
AS 47.33.005
AS 47.33.010
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