Haw. Code R. § 11-94.2-7 - Application

The applicant shall submit:

(1) An application on a form approved by the department with the following supporting documentation or information:

(A) Name, address, and contact information of the owner(s);

(B) Registration of corporation, articles of incorporation, limited liability company with a list of officers, directors, trustees, members, or advisory board members;

(C) Bylaws;

(D) Copy of documents recognizing the applicant's ability to do business in the State;

(E) An annual budget including all anticipated income and expenses demonstrating the facility's financial capability to ensure the health, safety, and welfare of residents; and

(F) Building plans indicating accurate measurements to scale of the entire facility with certificate of occupancy as appropriate;

(2) Documented compliance with current county building and land use codes;

(3) Documented compliance with current county fire code requirements;

(4) Documented clearance by the sanitation branch of the department;

(5) Documented clearance by the wastewater branch of the department;

(6) A certificate of need from the state health planning and development agency as determined by the State;

(7) All prospective applicants, licensees, operators, administrators, and direct resident access employees, and volunteers shall be screened for a history of abuse, neglect, or misappropriation of funds that includes but is not limited to fingerprint record checks through the Federal Bureau of Investigation and the Hawaii criminal justice data center, obtaining information from previous and current employers, and checking with the appropriate licensing boards and registries.

Notes

Haw. Code R. § 11-94.2-7

[Eff 9/16/2022] (Auth: HRS §§ 321-9, 321-11, 321-15.2) (Imp: HRS §§ 321-9, 321-11, 321-15.2)