Form Lic 281 - Application Instructions For A Facility License Page 14
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22B2.
VERIFICATION OF ADMINISTRATOR / DIRECTOR QUALIFICATIONS
Administrator/Director qualifications and duties are found in licensing regulations. When applicable,
these requirements must be verified by the following means by the applicant/licensee and provided to
the licensing agency as part of SECTION B:
COMMUNITY CARE FACILITIES (CCF’S) / ADULT RESIDENTIAL CARE FACILITIES (ARF’S) AND
RESIDENTIAL CARE FACILITIES FOR THE ELDERLY (RCFE)
For ARF only: Proof of registration in a 35-hour ARF certification program should be
submitted with the application. A Department issued certificate verifying completion of the 35-
hour ARF certification is required prior to licensure.
For RCFE only: Proof of registration in a 40-hour certification program should be submitted
with the application. A Department issued certificate verifying completion of the 40-hour
RCFE certification program by an approved vendor is required prior to licensure.
For GH only: Proof of registration in a 40-hour certification program should be submitted
with the application. A Department issued certificate verifying completion of the 40-hour GH
certification program by an approved vendor is required prior to licensure.
Education:
Transcripts from an accredited school, when required.
Out-of-Country school - In order to determine that the appropriate classes and number of
units have been completed, the applicant/licensee should obtain a copy of the class
descriptions or college catalog describing the class or obtain certification from a local college
regarding class equivalency. All state universities have an international programs office which
may be contacted to determine the status of courses offered by foreign colleges and
universities.
Experience:
Written references are to be obtained by the applicant/licensee and submitted to the licensing
agency. References are used solely to determine that the experience requirement is met (i.e.,
the person worked there, in the particular capacity, the specific duties performed, for a
specified period of time). If it is not possible to obtain a written reference (i.e., the person is
out of business and there is no means of contact), the applicant/licensee may submit a
declaration signed by the Administrator stating why written references are not able to be
obtained, that he/she worked in a particular capacity at a particular place/facility, the
specific duties performed, and for a specified period of time.
VERIFICATION OF EXPERIENCE FOR AN APPLICANT APPLYING FOR A ONE TO SIX BED
ARF OR RCFE IS NOT NECESSARY.
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