PDFWAC 388-101-3050

Application for initial certification.

(1) To apply for initial certification an applicant must submit to the department:
(a) A letter of intent that includes:
(i) Contact information;
(ii) Geographical area of service; and
(iii) Type of service provided, including group home, supported living, community protection, or group training home.
(b) A completed and signed application on forms designated by the department;
(c) All attachments specified in the application and any other information the department may request including but not limited to:
(i) Administrator resumes;
(ii) Statements of financial stability;
(iii) Professional references;
(iv) Relevant experiences and qualifications of the individual or agency; and
(v) Assurances the applicant will not discriminate against any client or employee.
(d) A copy of the license if applying for certification as a group home;
(e) The name of the administrator of the program; and
(f) The department background authorization form for:
(i) The applicant;
(ii) Anyone associated with the applicant; and
(iii) The individual or individuals designated to serve as administrator of the proposed program.
(2) The applicant must submit a revised application, if any information on the application changes before the initial certification is issued.
(3) The department will only process a completed application.
(4) Each person named in the application for initial certification is considered separately and jointly by the department.
(5) Based on the documentation received, the department will notify the applicant in writing regarding the department's certification decision.
(6) The applicant must comply with additional requirements identified in this chapter if intending to support community protection clients.
[Statutory Authority: RCW 71A.12.030 and [71A.12].080. WSR 12-02-048, § 388-101-3050, filed 12/30/11, effective 1/30/12. Statutory Authority: RCW 71A.12.080, chapter 74.39A RCW. WSR 10-16-084, § 388-101-3050, filed 7/30/10, effective 1/1/11. Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-3050, filed 12/21/07, effective 2/1/08.]