Ariz. Admin. Code § R21-7-108 - License Renewal Requirements

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.

E. The Agency shall comply with the annual Central Registry Check as prescribed in R21-7-104(D)(6).

Notes

Ariz. Admin. Code § R21-7-108

New Section made by final rulemaking at 29 A.A.R. 2231, effective 11/6/2023.