Licensing Requirements List

housesThe following items are required for licensure:

  • Statement of Need from the Community-Based Care Lead Agency
  • Application listing the proposed licensed location
  • Request and receipt of other cost accumulator (OCA) # for background screening
  • Program Policies and Procedures Handbook
  • House Rules/Protocols and/or additional Operational Procedures
  • Employee Handbook (if applicable)
  • Background information about your organization
  • Program description to include description of population to be served
  • Registration as an organization with the Florida Department of State Divisions of Corporations
  • Affidavit of Compliance Form, complete with attestation of mandated background screening clearance dates for all employees
  • List of employees with job title
  • Job descriptions for each job title
  • Six-month budget with proof of six-month funds to meet expenses
  • Projected staff schedule for 4-week period
  • Sample menus for 4-week period
  • Sample activity schedule
  • Sample daily schedule
  • Educational resources specific to population
  • Sample Independent Living program (i.e. outline of activities, group meeting schedule, group meeting topics, etc.)
  • Zoning form
  • Radon test
  • Facility main phone number
  • Evacuation plan, complete with a floor plan
  • Fire inspection
  • Health inspection
  • Minimum of two licensing visits to the facility
  • Personnel file review
  • List of community partners, include finalized working agreement/memorandum of understanding with applicable community partners
  • Client sign-out policy (i.e. sign-out for unsupervised time in the community), complete with sample sign-out form/log
  • Sample medication log
  • Blank client service plan
  • Proof of agency vehicle with insurance
  • Staff training plan, complete with sample schedule and topics for pre-service and in-service (separate from policies)
  • Organizational chart
  • List of Board of Directors, complete with by-laws