Section 78205 - Content of Application(a) Any corporation, company, partnership, or city or county government, which desires to obtain a license or a special permit shall file with the Department an application on forms furnished by the Department. The application shall contain the following information: (2) Name and address and professional qualifications of the administrator and program director.(3) A copy of articles of incorporation, constitution and bylaws of the corporation, company, or partnership.(4) A copy of the current organizational chart.(5) A brief history and general description of the function of the organization.(6) Information about each member of the governing board.(7) A statement of projected revenues, expenditures and cashflow on a monthly basis for a one-year period.(8) Name, address and location of center and a map identifying the service area.(9) Plan of operation as specified in Section 78403.(10) A statement as to whether the applicant is licensed or has ever been licensed to operate a health or community care facility.(11) A copy of each subcontract related to securing health care services, administrative and management services or any other services necessary to fulfill the center's provider obligations.(12) A copy of each agreement with at least a general acute care hospital, a physician and an ambulance service for the provision of emergency service.(13) A copy of each agreement with other community services, such as home health agencies, homemaker/chore, visiting nurses, transportation and nutrition programs designed for the disabled and elderly and senior centers.(14) A copy of the nondiscrimination policy.(15) A copy of the participant grievance procedure.(16) A copy of the procedure for utilization review.(17) Any other information requested by the Department.(b) Each application for a new license shall be submitted to the Adult Day Health Care Review Committee which shall send the application to the Adult Day Health Planning Council for the county in which the adult day health center is located.(c) Applicants who are funded as of December 31, 1977 to provide adult day health care services pursuant to Section 14124.7 of the Welfare and Institutions Code shall be exempt from conformity with the county plan as a condition of licensure.(d) The Department shall notify the applicant within 60 days if the application is incomplete.(e) If, after 120 days the application remains incomplete, the applicant shall be notified that the application is considered withdrawn, and a new application is required.(f) The applicant shall be given the opportunity to appeal the determination that the application is incomplete and to receive instead a notice of denial.Cal. Code Regs. Tit. 22, § 78205
1. Amendment of subsection (b) filed 9-20-79; effective thirtieth day thereafter (Register 79, No. 38).
2. Change without regulatory effect amending subsections (a) and (a)(3) and amending NOTE filed 6-20-2022 pursuant to section 100, title 1, California Code of Regulations (Register 2022, No. 25). Note: Authority cited: Sections 20, 1254, 1275 and 131200, Health and Safety Code. Reference: Sections 1575.1, 1575.2, 1576, 1580, 131050, 131051 and 131052, Health and Safety Code.
1. Amendment of subsection (b) filed 9-20-79; effective thirtieth day thereafter (Register 79, No. 38).
2. Change without regulatory effect amending subsections (a) and (a)(3) and amending Note filed 6-20-2022 pursuant to section 100, title 1, California Code of Regulations (Register 2022, No. 25).