Ohio Code > Title 37 > Chapter 3722 > § 3722.02 - Applying for license as adult care facility
A person seeking a license to operate an adult care facility shall submit to the director of health an application on a form prescribed by the director and the following:
(A) In the case of an adult group home seeking licensure as an adult care facility, evidence that the home has been inspected and approved by a local certified building department or by the division of industrial compliance in the department of commerce as meeting the applicable requirements of sections 3781.06 to 3781.18 and 3791.04 of the Revised Code and any rules adopted under those sections and evidence that the home has been inspected by the state fire marshal or fire prevention officer of a municipal, township, or other legally constituted fire department approved by the state fire marshal and found to be in compliance with rules adopted under section 3737.83 of the Revised Code regarding fire prevention and safety in adult group homes;
(B) Valid approvals of the facility’s water and sewage systems issued by the responsible governmental entity, if applicable;
(C) A statement of ownership containing the following information:
(1) If the owner is an individual, the owner’s name, address, telephone number, business address, business telephone number, and occupation. If the owner is an association, corporation, or partnership, the business activity, address, and telephone number of the entity and the name of every person who has an ownership interest of five per cent or more in the entity.
(2) If the owner does not own the building or if the owner owns only part of the building in which the facility is housed, the name of each person who has an ownership interest of five per cent or more in the building;
(3) The address of any adult care facility and any facility described in divisions (A)(9)(a) to (h) of section 3722.01 of the Revised Code in which the owner has an ownership interest of five per cent or more;
(4) The identity of the manager of the adult care facility, if different from the owner;
(5) The name and address of any adult care facility and any facility described in divisions (A)(9)(a) to (h) of section 3722.01 of the Revised Code with which either the owner or manager has been affiliated through ownership or employment in the five years prior to the date of the application;
(6) The names and addresses of three persons not employed by or associated in business with the owner who will provide information about the character, reputation, and competence of the owner and the manager and the financial responsibility of the owner;
(7) Information about any arrest of the owner or manager for, or adjudication or conviction of, a criminal offense related to the provision of care in an adult care facility or any facility described in divisions (A)(9)(a) to (h) of section 3722.01 of the Revised Code or the ability to operate a facility;
(8) Any other information the director may require regarding the owner’s ability to operate the facility.
(D) If the facility is an adult group home, a balance sheet showing the assets and liabilities of the owner and a statement projecting revenues and expenses for the first twelve months of the facility’s operation;
(E) Proof of insurance in an amount and type determined in rules adopted by the public health council pursuant to this chapter to be adequate;
(F) A nonrefundable license application fee in an amount established in rules adopted by the public health council pursuant to this chapter.
Effective Date: 09-26-1996; 05-27-2005; 07-01-2005Prev | Next
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