Or. Admin. Code § 411-049-0135 - [Effective 9/27/2024] License Applications
(1) INITIAL LICENSE
APPLICATION. The initial license application (APD 0448) must include:
(a) Verification of attendance at a
Department-approved orientation program conducted by the LLA responsible for
the licensing of the proposed AFH and successful completion of the Department's
Ensuring Quality Care Course and examination. (See OAR
411-049-0125).
(b) Three personal references for the
applicant who are not family members as defined in OAR
411-049-0102. Current or
potential licensees and co-workers of current or potential licensees are not
eligible as personal references.
(c) The classification being requested with
information and supporting documentation regarding qualifications, relevant
work experience, and training of staff as required by the Department. To
request a Class 3 license, the application must include:
(A) Proof of at least three years of
full-time experience providing direct care to adults who are older or adults
with physical disabilities and who required full assistance in four or more of
activities of daily living.
(B)
Current contact information from at least two licensed health care
professionals who have direct knowledge of the applicant's abilities and
experience as a caregiver; or
(C) A
copy of the applicant's current unencumbered license as a healthcare
professional in Oregon, if applicable.
(d) Documentation of the initiation of a
background check or a copy of an approved background check for each subject
individual as defined in OAR
411-049-0102.
(e) A Health History and Physician,
Physician's Assistant, or Nurse Practitioner's Statement (form APD 0903)
regarding the applicant's ability to provide care.
(f) FINANCIAL INFORMATION. A completed AFH
Financial Information form (APD 0448A), and supplemental information listed in
OAR 411-049-0125(3)
documenting at least two months of liquid resources to pay the operating costs
of the home.
(g) If an applicant
uses income from another AFH to document possession of at least two months of
operating expenses, the applicant must demonstrate the financial ability and
maintain sufficient liquid resources to pay the operating costs of each home
for at least two months.
(h) Copies
of the home's Residency Agreements according to OAR
411-050-0750.
(i) If the applicant is purchasing or owns
the home, verification of purchase or ownership.
(j) If the home is leased or rented, a copy
of the completed lease or rental agreement. The agreement must be a standard
lease or rental agreement for residential use and include the following:
(A) The owner and landlord's name.
(B) Verification that the rent is a flat
rate.
(C) The signatures of the
landlord and applicant and the date signed.
(k) Complete contact information for the
applicant including:
(A) A mailing address if
different from the proposed AFH.
(B) A business address for electronic
mail.
(l) The maximum
resident capacity requested.
(m)
Identify an Oregon-licensed registered nurse who has agreed to provide RN
consultation, training and delegation to caregivers as needed.
(n) Identification of:
(A) Any relatives needing care.
(B) The maximum number of any room and board
tenants.
(C) The maximum number of
adult day services individuals.
(D)
The names of any other occupants in the home.
(o) A $20 per bed non-refundable fee for each
non-relative resident.
(p) If the
applicant intends to use an administrator, resident manager, floating resident
manager, or shift caregivers, the Department's supplemental application (form
APD 0448B) completed by the applicant, as appropriate.
(q) Succession Plan or current AFH Back-up
Provider Agreement form (APD 0350).
(r) The current AFH Weekly Plan of Operation
form (APD 0351) describing the operational plan for the AFH.
(s) A current and accurate floor plan that
indicates:
(A) The size of rooms.
(B) Which bedrooms are to be used by
residents, the licensee, caregivers, for adult day services, and room and board
tenants, as applicable.
(C) The
location of all the exits on each level of the home, including emergency exits
such as windows.
(D) The location
of any wheelchair ramps.
(E) The
location of all fire extinguishers, smoke alarms, and carbon monoxide
alarms.
(F) The planned evacuation
routes, initial point of safety, and final point of safety.
(G) Any designated smoking areas in or on the
AFH premises.
(t) A copy
of the applicant's current license as a health care professional in Oregon, if
applicable.
(u) Incomplete initial
applications are void after 60 calendar days from the date the LLA receives the
application form and non-refundable fee, and the Department may deny the
application if not withdrawn.
(2) MULTIPLE HOMES. An applicant may not be
licensed to operate a second AFH, or any additional home, without first
demonstrating a history of substantial compliance for previous and currently
licensed AFHs.
(a) A separate application is
required for each location where an AFH is to be operated.
(b) A written plan describing the
administrative responsibilities and staffing to cover each home is
required.
(c) The applicant must
complete the Department's application form for the specific type of license
requested and submit the application form to the LLA with the non-refundable
fee.
(d) Applications are not
complete until all the required information is submitted to the LLA. Failure to
provide complete and accurate information may result in the denial of the
application.
(e) The applicant may
withdraw their application at any time during the application process by
written notification to the LLA.
(f) An applicant whose license has been
revoked, non-renewed, voluntarily surrendered during a revocation or
non-renewal process, or whose application for licensure has been denied, shall
not be granted a new license by the LLA for a period of not less than one year
from the date the action was final, or for a longer period if specified in the
final order.
(g) All moneys
collected under ORS 443.725 to
443.825 are paid to the Quality
Care Fund.
(3) LICENSE
RENEWAL. At least 90 calendar days prior to the expiration of a license, the
LLA must send a reminder notice and renewal application to the licensee.
License renewal inspections may be conducted with an appointment when requested
by a licensee or administrator. The request must be made no less than 30 days
prior to the expiration of the license and the appointment must be scheduled at
a mutually agreed upon time in cooperation with the LLA. If advance notice may
obstruct or diminish the effectiveness of the enforcement of these rules, the
appointment request may be denied.
(a) The
application (form APD 0448C) must be completed and timely submitted with the
required non-refundable fee to the LLA prior to the expiration date of the
current license. Timely submission of the renewal application and fee shall
keep the license in effect until the LLA or the Department takes action. The
complete application will include:
(A) The
requirements listed in (1)(i) through (r) of this rule.
(B) A Health History and Physician or Nurse
Practitioner's Statement (form APD 0903). The Health History and Physician or
Nurse Practitioner's Statement must be updated every third year or sooner if
there is reasonable cause for health concerns.
(C) FINANCIAL INFORMATION FOR THE HOME'S
FIRST LICENSE RENEWAL. A completed Financial Information Worksheet (form APD
0448A) demonstrating the financial ability to maintain sufficient liquid
resources to pay the home's operating costs for at least two months.
(D) Documentation of a current approved
background check for each subject individual according to OAR
411-049-0120.
(E) Copies of the home's Residency Agreement
forms if changes to the original forms reviewed by the LLA are
proposed.
(F) Proof of required
annual training as specified in OAR
411-049-0125(8).
(b) A renewal application
remaining incomplete at the time of license expiration, or failure to provide
accurate information on the renewal application may result in the denial of the
application.
(4) LOCAL
LICENSING AUTHORITY AND DEPARTMENT ACTION. After receipt of the completed
application materials, including the non-refundable fee:
(a) FOR INITIAL LICENSE APPLICATIONS:
(A) The LLA must investigate the information
submitted including pertinent information received from outside sources,
conduct a personal interview with the applicant, and conduct an in-person
inspection of the home identifying any deficiencies on the Department's APD
0516 form, and specify a time frame for correction not to exceed 30
days.
(B) The licensee must be
given a copy of the Department's inspection form (APD 0516).
(C) The LLA must issue a license within 60
calendar days after the completed application materials have been received if
the home and applicant are in compliance with these rules.
(D) The Department shall deny the issuance of
a license if deficiencies cited are not corrected within the time frames
specified by the LLA.
(b) FOR RENEWAL LICENSE APPLICATIONS:
(A) The LLA shall investigate the information
submitted, review the licensing records for the applicant, conduct an in-person
inspection of the home, and provide the licensee a copy of the Department's
Statement of Deficiencies and Plan of Correction form identifying any
violations and specifying a time frame for correction not to exceed 30
days.
(B) The Department may deny a
renewal application if cited deficiencies are not corrected within the time
frame specified by the LLA.
(C)
EXPIRED AND UNLICENSED ADULT FOSTER HOME. If the required renewal information
and fee are not timely submitted to the LLA as required in (3) of this rule and
residents remain in the home after the date the license expires, the home shall
be treated as an unlicensed facility, subject to civil and criminal penalties
(See OAR 411-052-0025 and OAR
411-052-0045).
(c) The licensee or administrator
must post the most recent inspection reports, according to OAR
411-049-0140, and must provide
upon request a copy of the reports to each resident, person applying for
admission to the home, or the legal representative, guardian, or conservator of
a resident.
(d) The Department may
attach conditions to the license that limit, restrict, or specify other
criteria for operation of the home. The conditions must be visibly posted with
the license.
Notes
Statutory/Other Authority: ORS 409.050, 410.070, 413.085, 443.001, 443.004, 443.725, 443.730, 443.735, 443.738, 443.742, 443.760, 443.767, 443.775 & 443.790
Statutes/Other Implemented: ORS 409.50, 410.070, 413.085, 443.001 - 443.004, 443.705 - 443.825, 443.875 & 443.991
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