Section 11-148.1-5 - Application and documentation for substitute caregiver applicant(a) A substitute caregiver applicant shall submit a written application on forms prescribed by the certifying agency.(b) An application is not complete until the certifying agency receives a written application which contains all information and supporting documentation required by this chapter.(c) Applicants may mail applications and supporting documents to the certifying agency; and(d) Incomplete applications will not be processed by the certifying agency.(e) The application shall include: (1) A physician's statement regarding the applicant's ability to provide care to adults with I/DD;(2) A signed consent form and all applicable processing fees so that the department or its designee can conduct a background check in accordance with section 11-148.1-44, which includes fingerprinting and employment history;(3) Verification of the applicant's current tuberculosis clearance, in accordance with current department of health examination procedures and regulations, chapter 11164.2, HAR;(4) Verification of the applicant's current certification in first aid and cardiopulmonary resuscitation;(5) Verification of the applicant's license to practice as a registered nurse or licensed practical nurse; or certification to practice as a certified nurses aid, if applicable; and(6) Any other requirements in accordance with departmental policy.(f) An applicant may withdraw the application at any time during the application process by notifying the certifying agency in writing.Haw. Code R. § 11-148.1-5
[Eff 8/2/2021] (Auth: HRS §§ 321-9, 321-11.2) (Imp: HRS §§ 321-11.2, 321-15.2, 846-2.7)