WAC 246-335-025   Initial application.  An applicant for initial licensure or additional in-home service category must:

     (1) Submit to the department:

     (a) A completed application on forms provided by the department;

     (b) Evidence of current professional liability insurance in the amount of one hundred thousand dollars per occurrence and public liability and property damage insurance in the amount of two hundred thousand dollars per occurrence as a minimum. This subsection does not apply to hospice applicants that provide in-home hospice care without receiving compensation for delivery of services;

     (c) Disclosure statements and criminal history background checks obtained within three months of the application date for the administrator and director of clinical services or supervisor of direct care services in accordance with RCW 43.43.830 through 43.43.845;

     (d) The following information:

     (i) Name of managing personnel, officers, administrator, director of clinical services or supervisor of direct care services, and partners or individuals owning ten percent or more of the applicant's assets;

     (ii) A description of the organizational structure;

     (iii) A description of the in-home services categories to be offered directly or under contract;

     (iv) Name, address, and phone numbers of all office locations that provide services within the state;

     (v) A copy of the current business license(s);

     (vi) A description of the service area for which the applicant is requesting to provide services;

     (vii) Other information as required by the department;

     (viii) Fees specified in WAC 246-335-990; and

     (2) Develop and approve policies and procedures addressing the content of this chapter; and

     (3) Meet the requirements of this chapter as determined by an initial survey conducted by the department.



[Statutory Authority: Chapter 70.127 RCW. 02-18-026, § 246-335-025, filed 8/23/02, effective 10/1/02.]