Minn. R. agency 196, ch. 9555, ADULT FOSTER CARE SERVICES AND LICENSURE OF ADULT FOSTER HOMES, pt. 9555.5515 - RECORD ON THE RESIDENCE
A record for the residence licensed as an adult foster home shall be maintained by the commissioner and contain:
A. a copy of the completed licensing
application form signed by the applicant and the representative of the
commissioner, as specified in part
9555.6115, subpart
1;
B. the physician's reports on caregivers and
household members specified in part
9555.6125 if the operator is an
individual;
C. the initial and
subsequent inspection report from the fire marshal specified in part
9555.6125 and the subsequent home
safety checklists;
D. any written
inspection reports from a health authority or building official;
E. the commissioner's initial and any renewal
licensing studies and inspections;
F. any comments of the operator or provider
about the licensing studies and inspections;
G. written references from at least three
persons who know about the applicant's potential to operate an adult foster
home. If the applicant has been licensed through another jurisdiction, the
local agency shall also request and keep a reference from the licensing
authority in that jurisdiction;
H.
a list of residents currently in the residence;
I. a list of residents who have been in the
residence in the past five years;
J. documentation of any variances to parts
9555.6105 to
9555.6265;
K. arrest, conviction, and criminal history
records on the operator, caregivers, and household members;
L. if the operator is a partnership,
corporation, or governmental unit, the information required in part
9555.6125, subpart 3, item C,
subitems (1), (2), (3), (6), and (7);
M. a copy of the commissioner approved,
written adult foster home program required in part
9555.6235;
N. a record of any substantiated complaints
of maltreatment as defined in Minnesota Statutes, section
626.5572, subdivision
15, and any corrective action taken under parts
9555.7100 to
9555.7600; and
O. a copy of the facility abuse prevention
plan required under the Vulnerable Adults Act.
Notes
Statutory Authority: MS s 14.386; 14.388; 256.01; 256E.03; 256E.05; 256E.08; 393.07
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