Ariz. Admin. Code § R9-33-104 - Application and Inspection
A. For a license
to operate a group home or behavioral-supported group home, an applicant shall
submit to the Department a completed application that contains:
1. An application in a Department provided
format that includes:
a. The applicant's
name;
b. The proposed group home's
or behavioral-supported group home's name, if any;
c. The address and telephone number of the
proposed group home or behavioral-supported group home;
d. The applicant's address and telephone
number, if different from the address or telephone number of the proposed group
home or behavioral-supported group home;
e. The applicant's e-mail address;
f. The name and contact information of an
individual acting on behalf of the applicant according to
R9-33-103, if applicable;
g. Whether the applicant agrees to allow the
Department to submit supplemental requests for information under
R9-33-108(C)(4);
h. Whether the applicant is a current service
provider or intends to become a service provider;
i. The fire risk prevention level at which
the applicant anticipates operating the group home or behavioral-supported
group home; and
j. The applicant's
signature and the date signed;
2. A copy of the applicant's:
a. U.S. passport, current or
expired;
b. Birth
certificate;
c. Naturalization
documents; or
d. Documentation of
legal resident alien status;
3. A copy of the applicant's:
a. Current service provider contract with the
Division indicating that services are to be provided at the address of the
proposed group home or behavioral-supported group home; or
b. Documentation from the Division
demonstrating that the applicant has a service provider contract pending for
providing services at the address of the proposed group home or
behavioral-supported group home; and
4. A copy of the applicant's accreditation
report issued by a nationally recognized accreditation organization, if
applicable.
B. An
applicant or licensee shall allow the Department immediate access to all areas
of the premises, a resident, record, or vehicle used to transport a resident,
according to A.R.S. §
41-1009.
C.
Upon receipt of the application packet in subsection
(A), the Department shall issue or deny a license to an applicant as provided
in R9-33-108 .
Notes
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