Current through Register Vol. 27, No. 52, December 24, 2021
A. To become certified to provide a Home and
Community-based Service to a client, an applicant shall file an application for
an HCBS certificate with the Division and meet the requirements of this
The applicant shall
complete application for an initial HCBS certificate on a form prescribed by
the Division. The form shall contain the following information:
2. Home and business address,
3. Specific services for which application is
4. Phone number,
5. Social security number or tax
declaration regarding criminal history of offenses listed in
7. Description of
work experience, and
of educational background.
C. The applicant shall provide a copy of any
other license or certificate required by this Article to provide a specific
D. Except as provided by
R6-6-1521, the applicant shall provide forms for three letters of reference to
individuals who are not the applicant's family members and who have personal
knowledge about the applicant's employment history, education, or character.
The letters will be on forms provided by the Division. The individual giving
the reference shall send the completed reference form to the
E. The Division shall be
in receipt of a completed application and three letters of reference before
considering certification of the applicant.
F. The applicant shall provide the Division
with written documentation signed by the person performing the inspection of
the completion of the requirements of
G. Within 60 days of receipt of an
application, the Division shall notify the applicant of any missing documents
or information. The Division shall allow 30 days from the date of notification
to the applicant for submission of the remaining documents or information and,
if not received at that time, may close the record.
H. The Division shall conduct background
checks with Child Protective Services and Adult Protective Services on
applicants when information in the application indicates a past history of
child or elder abuse. The Division shall utilize the background check
information when determining whether to certify an applicant.