Note: To obtain a copy of the application form, contact the county agency in which the home is located or write or phone the appropriate regional office of the Department's Division of Disability and Elder Services. See Appendix A for addresses and phone numbers of the Division of Disability and Elder Services regional offices.
Note: Examples of actions the Department will consider in making a determination that an act substantially relates to the care of adults or minors, the funds or property of adults or minors or activities of the adult family home are: abuse, neglect, sexual assault, indecent exposure, lewd and lascivious behavior, or any crime involving non-consensual sexual conduct; child abuse, sexual exploitation of children, child abduction, child neglect, contributing to the delinquency or neglect of a child, enticing a child, enticing a child for immoral purposes, exposing a minor to pornography or other harmful materials, incest, or any crime involving children as victims or participants; armed robbery, aggravated battery, false imprisonment, kidnaping, homicide, any crimes involving bodily harm or threat of bodily harm, any crime involving the use of a dangerous weapon or any crime evidencing disregard to health and safety; cruelty, neglect or abandonment of animals and instigating fights between animals; burglary, extortion, forgery, concealing identity, embezzlement and arson; crimes involving a substantial misrepresentation of any material fact to the public including bribery, fraud, racketeering or allowing an establishment to be used for illegal purposes; offenses involving narcotics, alcohol or controlled substances that result in a felony conviction, operating a motor vehicle while under the influence of an intoxicant or other drug, operating after revocation and leaving the scene of an accident after injury or death to a person or damage to a vehicle driven or attended by any person.
Note: Wisconsin's Fair Employment Act, ss. 111.31 to 111.395, Stats., prohibits discrimination because of a criminal record or a pending charge, unless the record or charge substantially relates to the circumstances of the particular job or licensed activity.
Note: The department's registry for nurse assistants, home health aides and hospice aides can be reached by calling (608) 266-5545 to receive the information you need from an automated voice response unit, or you may call (608) 267-2374.
Note: Refer to the note under s. DHS 88.03(3) (b) for examples of actions to be considered in making a determination that an act substantially relates to the care of adults or minors, the funds or property of adults or minors or activities of the adult family home.
Note: Deaths not to be reported to the licensing agency are those resulting from natural causes such as heart attach, a stroke or an illness when none of the circumstances in par. (e) 1. and 2. exist.
Note: Providing notice under this subsection does not relieve the licensee or other persons of any obligation to report an incident to any other agency including law enforcement.
Note: A request for a hearing should be submitted to the Division of Hearings and Appeals, P.O. Box 7875, Madison, Wisconsin 53707.
Wis. Admin. Code Department of Health Services DHS 88.03