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					                                                    State Permits Required for Businesses in Washington State
                                                                  Department of Social and Health Services

                                                                                                  Uses of Permit (If more than one)
                                                                                                  Identified on the Agency's Website Where Permit Application is                              Where Business Submits the Permit
Permit Name   Permit Category   Purpose of Permit          Business Activities Requiring Permit   or Application                     Available                     Form # and Revision Date   Application                       Required Frequency of Renewal
                                                        State Permits for Businesses in Washington State
                                               State Permits RequiredRequired for Businesses in Washington State
                                                                                Department of Health Services
                                                                        Department of Social andSocial and Health Services

                                                                                  Permit Processing Time Identified   Total Number of Initial Permit
                                                                                  on the Agency's Website or          Applications Received in 2006-2010 Currently Exists on ORA
Permit Name   RCW Governing Permit   WAC Governing Permit   Fee for Permit        Application                         (Calendar year)                    Website                   Source   Agency Comments
                                                                                                      State Licenses1 Required for Businesses in Washington State
                                                                                                                                      Department of Social and Health Services

                                                                                                                                                                                Uses of License (If more than one)
                                                                                                                                                                                Identified on the Agency's Website Where License Application is                                                      Where Business Submits the
License Name                       License Category                         Purpose of License                               Business Activities Requiring License              or Application                     Available                                  Form # and Revision Date               License Application                 Required Frequency of Renewal
Community Mental Health Services   Aging and Disability Services - Division To license a mental health facility              Agencies providing mental health services          Emergency Crisis Intervention       http://www.dshs.wa.gov/pdf/ms/forms/ DSHS 10-165 (REV. 09/2005)                  DSHS, Mental Health Division
License                            of Behavioral Recovery Services                                                                                                              Services; Case Management Services; 10_165.pdf
                                   (DBHR)                                                                                                                                       Psychiatric Treatment (including
                                                                                                                                                                                medication supervision); Counseling
                                                                                                                                                                                and Psychotherapy Services; Day
                                                                                                                                                                                treatment; Consumer Employment
                                                                                                                                                                                Services; Peer support services




Adult Family Home (AFH) License    Aging and Disability Services -          To allow persons or entities to provide care for A business providing personal care, special                                                http://www.dshs.wa.gov/pdf/ms/forms/ DSHS 10-410 (REV. 08/2011)              ADSA Finance and Contracts          Does not have to renew the license,
                                   Residential Care Services (RCS)          up to six adults not related by blood or marriage care, room, and board to more than one but not                                            10_410.pdf                                                                                                       but must pay an annual licensing fee
                                                                            to the person or persons providing the services more than six adults not related to the caregiver




Boarding Home (BH) License         Aging and Disability Services -          To allow individuals or entities to operate a    Any home or other institution providing; 1)         Medicaid contracts; Assisted Living;   http://www.adsa.dshs.wa.gov/Professi Application – Initial License 04/2011   DSHS Aging & Disability Services,   Valid for one year
                                   Residential Care Services (RCS)          boarding home                                    housing, basic services, and assuming general Adult Residential; Enhanced Adult            onal/bh/revisedapps/INITIAL.doc                                              Residential Care Services
                                                                                                                             responsibility for the safety and well-being of the Residential
                                                                                                                             residents, and 2) domiciliary care to seven or
                                                                                                                             more residents after July 1, 2000




Nursing Home (NH) License          Aging and Disability Services -          To allow individuals or entities to operate a    A business operating or maintaining facilities   Federal Medicare; Medicaid                http://www.adsa.dshs.wa.gov/Professi Application – Initial License – NH      DSHS Aging & Disability Services,   Valid for one year
                                   Residential Care Services (RCS)          nursing home                                     providing convalescent and/or chronic care for Certification                               onal/nh/revisedapps/Initial%20License 8/2011                                 Residential Care Services
                                                                                                                             over twenty-four consecutive hours, for three or                                           .doc
                                                                                                                             more patients not related by blood or marriage
                                                                                                                             to the operator, who are unable to properly care
                                                                                                                             for themselves
                                                                                    State Licenses1 1 Required for Businesses in Washington State
                                                                                     State Licenses Required for Businesses in Washington State
                                                                                                                  Department of Social and Health Services
                                                                                                                 Department of Social and Health Services

                                                                                                                         License Processing Time Identified Total Number of Initial License
                                                                                                                         on the Agency's Website or         Applications Received in 2006-2010 Currently Exists on   Currently Exists on
License Name                       RCW Governing License   WAC Governing License   Fee for License                       Application                        (Calendar year)                    BLS Website           ORA Website           Source                                            Agency Comments
Community Mental Health Services   RCW 71.24               WAC 388-865             $291 - $1,030. See WAC 388-865-0474                                                                         No                    No                    http://www.dshs.wa.gov/dbhr/mhlicensing.shtml
License




Adult Family Home (AFH) License    RCW 70.128              WAC 388-76              $2,750                                60 days or more                    2,389                              No                    No                    http://www.adsa.dshs.wa.gov/professional/afh/a The number of initial license applications
                                                                                                                                                                                                                                           pplications.htm                                includes new and change of ownership
                                                                                                                                                                                                                                                                                          applications (1,558 new and 831 change of
                                                                                                                                                                                                                                                                                          ownerships). Change of ownership applications
                                                                                                                                                                                                                                                                                          were included because the applicant (assuming
                                                                                                                                                                                                                                                                                          licensure) is applying for its first license at that
                                                                                                                                                                                                                                                                                          specific address. WAC 388-76-10010 states
                                                                                                                                                                                                                                                                                          that an adult family home license is valid for the
                                                                                                                                                                                                                                                                                          person named in the application and the
                                                                                                                                                                                                                                                                                          address listed on the license.




Boarding Home (BH) License         RCW 18.20               WAC 388-78A             $106 per licensed bed                 4-6 months                         242                                No                    No                    http://www.adsa.dshs.wa.gov/Professional/bh/re The number of initial license applications
                                                                                                                                                                                                                                           visedapps/                                     includes new and change of ownership
                                                                                                                                                                                                                                                                                          applications (58 new and 184 change of
                                                                                                                                                                                                                                                                                          ownerships). Change of ownership applications
                                                                                                                                                                                                                                                                                          were included because the applicant (assuming
                                                                                                                                                                                                                                                                                          licensure) is applying for its first license at that
                                                                                                                                                                                                                                                                                          specific address. RCW 18.20.050 states that a
                                                                                                                                                                                                                                                                                          boarding home license is valid for the person
                                                                                                                                                                                                                                                                                          named in the application and the address listed
                                                                                                                                                                                                                                                                                          on the license.




Nursing Home (NH) License          RCW 18.51               WAC 388-97              $359 per bed                          90 days                            47                                 No                    No                    http://www.adsa.dshs.wa.gov/Professional/nh/re The number of initial license applications
                                                                                                                                                                                                                                           visedapps/                                     includes new and change of ownership
                                                                                                                                                                                                                                                                                          applications (2 new and 45 change of
                                                                                                                                                                                                                                                                                          ownerships). Change of ownership applications
                                                                                                                                                                                                                                                                                          were included because the applicant (assuming
                                                                                                                                                                                                                                                                                          licensure) is applying for its first license at that
                                                                                                                                                                                                                                                                                          specific address. RCW 18.51.050 states a
                                                                                                                                                                                                                                                                                          nursing home license is valid for the person
                                                                                                                                                                                                                                                                                          named in the application and the address listed
                                                                                                                                                                                                                                                                                          on the license.
                                                                                                         State Licenses1 Required for Businesses in Washington State
                                                                                                                                              Department of Social and Health Services

                                                                                                                                                                                         Uses of License (If more than one)
                                                                                                                                                                                         Identified on the Agency's Website Where License Application is                                       Where Business Submits the
License Name                             License Category                      Purpose of License                                    Business Activities Requiring License               or Application                     Available                               Form # and Revision Date   License Application                 Required Frequency of Renewal
Certified Community Residential          Aging and Disability Services-        To allow persons or entities to deliver services      Service providers who provide community             Supported living services; Group     Application is currently under revision DSHS 15-389 (10/2009)    ADSA, Business Analysis and         Regular certification for up to two
Services and Supports - State            Residential Care Services (RCS)       and support to meet a client's identified needs       residential services and support to clients. (No    homes; Community protection services and once revision is completed, will be                          Applications Unit                   years and extend for an additional
Certification for Service Provider                                                                                                   state licensure except for those licensed as        in supported living program          available online. Application can be                                                                 period up to one hundred and eighty
                                                                                                                                     boarding homes or adult family homes.)                                                   requested from ADSA, Business                                                                        days
                                                                                                                                                                                                                              Analysis and Applications Unit



Intermediate Care Facilities for             Aging and Disability Services-    To allow persons or entities to operate a certified   An institution providing active treatment serving                                        No application                                                   Contact Residential Care Services   N/A
Individuals with Intellectual Disabilities - Residential Care Services (RCS)   Medicare and/or Medicaid Intermediate Care            four or more beds for people with intellectual                                                                                                            (RCS)
Federal Certification                                                          Facilities for individuals with intellectual          disabilities or related conditions. (No state
                                                                               disabilities                                          licensure except for those licensed as boarding
                                                                                                                                     homes or nursing homes.)



Domestic Violence Perpetrator            Children's Administration (CA)        To ensure domestic violence programs meets            Any program wishing to provide treatment to                                              http://www.dshs.wa.gov/pdf/ms/forms/ DSHS 10-209 (08/2001)       DSHS, Children's Administration     Valid for two years
Treatment Program Certification                                                standards set in WAC 388-60                           perpetrators of domestic violence                                                        10_209.pdf




  1Includes Registrations and

  Certifications
                                                                                           State Licenses1 1 Required for Businesses in Washington State
                                                                                            State Licenses Required for Businesses in Washington State
                                                                                                             Department of Social and Health Services
                                                                                                            Department of Social and Health Services

                                                                                                                 License Processing Time Identified Total Number of Initial License
                                                                                                                 on the Agency's Website or         Applications Received in 2006-2010 Currently Exists on   Currently Exists on
License Name                              RCW Governing License   WAC Governing License   Fee for License        Application                        (Calendar year)                    BLS Website           ORA Website           Source                                            Agency Comments
Community Mental Health Services
Certified Community Residential           RCW 71A.12              WAC 388-101             No fee                 60 days or more (as noted on       20                                 No                    No                    http://www.adsa.dshs.wa.gov/professional/crs.ht
License and Supports - State
Services                                                                                                         application)                                                                                                      m
Certification for Service Provider




Intermediate Care Facilities for             42 CFR 483           WAC 388-111             N/A                                                       0                                  No                    No                    http://www.adsa.dshs.wa.gov/professional/icfmr. No state licensure WACs. Due process WACs
Individuals with Intellectual Disabilities -                                                                                                                                                                                       htm                                             (WAC 388-11) pertain to Residential Habilitation
Federal Certification                                                                                                                                                                                                                                                              Centers.




Domestic Violence Perpetrator             RCW 26.50               WAC 388-60              $100                   Within 30 days                     30                                 No                    No                    http://www.dshs.wa.gov/ca/dvservices/perptreat. Approximate number; to obtain specific count,
Treatment Program Certification                                                                                                                                                                                                    asp                                             CA would have to review all program files
                                                                                                                                                                                                                                                                                   including archived records.


  1Includes Registrations and

  Certifications
                                                                                                    State Inspections Required for Businesses in Washington State
                                                                                                                                        Department of Social and Health Services

                                                                                                                                                                                    Uses of Inspection (If more than one)
                                                                                                                                Business Activities Requiring                       Identified on the Agency's Website or   How Inspection is Conducted (Site visit,
Inspection Name                         Inspection Category                    Purpose of Inspection                            Inspection                                          Application                             desk audit, etc)                         How a Business Requests an Inspection Required Frequency of Inspection
Inspections of business providing       Aging and Disability Services - Division To examine agency policies and procedures and Business providing Community Mental Health                                                   On-site review                                                                Consumer chart review - within 12 months of the
Community Mental Health Services        of Behavioral Recovery Services          any other information that may be necessary to Services, (preliminary consumer chart review if                                                                                                                           provisional license issuance
                                        (DBHR)                                   ensure compliance with minimum standards of applying for a new service component)
                                                                                 WAC 388-865


Adult Family Home Inspection            Aging and Disability Services -        To ensure that the home and provider are in Adult Family Homes (AFH)                                 Inspections; Complaint investigations   On-site inspection and investigation   No fee                                 At least every 18 months. AFH may be allowed
                                        Residential Care Services (RCS)        compliance with RCW 70.128 and WAC 388-76                                                                                                                                                                                  to continue without inspection for 2 years if the
                                                                                                                                                                                                                                                                                                          adult family home had no inspection citations for
                                                                                                                                                                                                                                                                                                          the past 3 consecutive inspections.


Boarding Home Inspection                Aging and Disability Services -        To ensure compliance with RCW 18.20, WAC         Boarding Homes (BH)                                 Inspections; Complaint investigations   On-site inspection and investigation   No fee                                 At least every 18 months with an annual
                                        Residential Care Services (RCS)        388-78A and WAC 388-110                                                                                                                                                                                                    average of 15 months. The department may
                                                                                                                                                                                                                                                                                                          delay an inspection to 24 months if the boarding
                                                                                                                                                                                                                                                                                                          home has had 3 consecutive inspections with no
                                                                                                                                                                                                                                                                                                          written notice of violations.



Contracted Residential Care             Aging and Disability Services -        To ensure compliance with RCW 18.20 and          Contracted Residential Care Facilities              Inspections; Complaint investigations   On-site inspection and investigation   No fee                                 At least every 18 months with an annual
Inspection                              Residential Care Services (RCS)        WAC 388-110                                                                                                                                                                                                                average of 15 months


Intermediate Care Facilities for           Aging and Disability Services -     To ensure compliance with requirements of 42     Intermediate Care Facilities for individuals with   Inspections; Complaint investigations   On-site evaluation and investigation   No fee                                 At least every year
Individuals with Intellectual Disabilities Residential Care Services (RCS)     CFR 483                                          intellectual disabilities (ICFID)
Survey

Nursing Home Inspection                 Aging and Disability Services -        To ensure compliance with the requirements of Nursing Homes (NH)                                     Inspections; Complaint investigations   On-site inspection and investigation   No fee                                 At least once prior to license renewal. All
                                        Residential Care Services (RCS)        RCW 18.51, RCW 74.42, WAC 388-97 and                                                                                                                                                                                       licenses shall expire on a date set by the
                                                                               relevant federal regulations                                                                                                                                                                                               department, but no license must exceed thirty
                                                                                                                                                                                                                                                                                                          six months.




Certified Community Residential         Aging and Disability Services-         To ensure compliance with requirements of        Certified Community Residential Services and        Inspections; Complaint investigations   On-site evaluation and investigation   No fee                                 At least once every two years
Services and Supports Evaluation        Residential Care Services (RCS)        RCW 71A.12 and WAC 388-101                       Supports (CCRSS)
                                                                    State Inspections Required for Businesses in State
                                                        State Inspections Required for Businesses in Washington Washington State
                                                                                      Department of Social and Health Services
                                                                          Department of Social and Health Services
                                                                                             Total Number of Times the
                                                                                             Agency Conducted the Initial
                                        RCW Governing   WAC Governing                        Inspection in 2006-2010        Currently Exists on
Inspection Name                         Inspection      Inspection      Fee for Inspection   (Calendar year)                ORA Website           Source                                             Agency Comments
Inspections of business providing       RCW 71.24       WAC 388-865                                                         No                    http://apps.leg.wa.gov/wac/default.aspx?cite=38
Community Mental Health Services                                                                                                                  8-865-0470




Adult Family Home Inspection            RCW 70.128      WAC 388-76      N/A                  1,715                          No                    http://apps.leg.wa.gov/rcw/default.aspx?cite=70.
                                                                                                                                                  128.070




Boarding Home Inspection                RCW 18.20       WAC 388-78A     N/A                  153                            No                    http://apps.leg.wa.gov/rcw/default.aspx?cite=18.
                                                                                                                                                  20.110




Contracted Residential Care             RCW 18.20       WAC 388-110     N/A                                                 No                    Provided by DSHS, Aging and Disability
Inspection                                                                                                                                        Services - Residential Care Services (RCS)


Intermediate Care Facilities for           42 CFR 483                   N/A                  0                              No                    Provided by DSHS, Aging and Disability             No WAC for surveys; using federal regulations
Individuals with Intellectual Disabilities                                                                                                        Services - Residential Care Services (RCS)
Survey

Nursing Home Inspection                 RCW 18.51       WAC 388-97      N/A                  47                             No                    http://apps.leg.wa.gov/wac/default.aspx?cite=38 State Operations Manual, under 7205A, states that each
                                                                                                                                                  8-97-4360                                       skilled nursing facility and nursing facility be subject to a
                                                                                                                                                                                                  standard survey no later than 15 months after the last day
                                                                                                                                                                                                  of the previous standard survey and that the statewide
                                                                                                                                                                                                  average interval between standard surveys should not
                                                                                                                                                                                                  exceed 12 months



Certified Community Residential         RCW 71A.12      WAC 388-101     N/A                  16                             No                    http://apps.leg.wa.gov/wac/default.aspx?cite=38
Services and Supports Evaluation                                                                                                                  8-101-3130

				
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