Ariz. Admin. Code § R4-33-206 - Renewal Application
A. The
Board shall provide a licensee with notice of the need for license renewal.
Failure to receive notice of the need for license renewal does not excuse a
licensee's failure to renew timely.
B. An administrator license expires at
midnight 30 days after the administrator's birthday in each even-numbered
year.
C. To renew an administrator
license, the licensee shall submit the following information to the Board,
before expiration of the biennial period, on a renewal application, which is
available from the Board:
1. Current
address;
2. Current e-mail
address;
3. Current home and
business telephone numbers;
4.
Whether within the last 24 months the licensee was convicted of or pled guilty
or no contest to a criminal offense, other than a minor traffic violation, in
any court and if so, attach a copy of the original arrest record and final
court judgment;
5. Whether within
the last 24 months the licensee was denied a professional license or had a
professional license revoked, suspended, placed on probation, limited, or
restricted in any way by a state or federal regulatory authority and if so, the
kind of license, license number, issuing authority, nature of the regulatory
action, and date;
6. An affirmation
that the number of hours of continuing education required under
R4-33-501 has been completed;
and
7. The licensee's dated
signature affirming the information provided is true and
complete.
D. In addition
to the renewal application required under subsection (C), a licensee shall
submit:
1. A photocopy of the front and back
of the licensee's fingerprint clearance card;
2. Documentation described in A.R.S. §
41-1080(A) unless the documentation previously submitted under
R4-33-204(C)(7)
established U.S. citizenship or was a non-expiring work authorization issued by
the federal government; and
3. The
license renewal fee required under
R4-33-104.
E. An individual whose license expires
because of failure to renew timely may apply for renewal by complying with
subsections (C) and (D) if:
3.
2. The
individual affirms the individual has not acted as a nursing care institution
administrator since the license expired, and
1. The individual complies with
subsections (C) and (D) on or before July 31,
3. The individual's license has not been
surrendered, suspended, or revoked.
Notes
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