1. A. For a license to operate a group home or behavioral-supported group home, an applicant shall submit to the Department a completed application that contains:

   1. 1. An application in a Department provided format that includes:

      1. a. The applicant’s name;
      2. b. The proposed group home’s or behavioral-supported group home’s name, if any;
      3. c. The address and telephone number of the proposed group home or behavioral-supported group home;
      4. d. The applicant’s address and telephone number, if different from the address or telephone number of the proposed group home or behavioral-supported group home;
      5. e. The applicant’s email address;
      6. f. The name and contact information of an individual acting on behalf of the applicant according to R9-33-103, if applicable;
      7. g. Whether the applicant agrees to allow the Department to submit supplemental requests for information under R9-33-108(C)(4);
      8. h. Whether the applicant is a current service provider or intends to become a service provider;
      9. i. The fire risk prevention level at which the applicant anticipates operating the group home or behavioral-supported group home; and
      10. j. The applicant’s signature and the date signed;

   2. 2. A copy of the applicant’s:

      1. a. U.S. passport, current or expired;
      2. b. Birth certificate;
      3. c. Naturalization documents; or
      4. d. Documentation of legal resident alien status;

   3. 3. A copy of the applicant’s:

      1. a. Current service provider contract with the Division indicating that services are to be provided at the address of the proposed group home or behavioral-supported group home; or
      2. b. Documentation from the Division demonstrating that the applicant has a service provider contract pending for providing services at the address of the proposed group home or behavioral-supported group home; and
   4. 4. A copy of the applicant’s accreditation report issued by a nationally recognized accreditation organization, if applicable.
2. B. An applicant or licensee shall allow the Department immediate access to all areas of the premises, a resident, record, or vehicle used to transport a resident, according to A.R.S. § 41-1009.

Historical Note

New Section made by final rulemaking at 8 A.A.R. 910, effective February 11, 2002 (Supp. 02-1). R9-33-104 renumbered to R9-33-105; new R9-33-104 renumbered from R9-33-103 and amended by final rulemaking at 18 A.A.R. 3295, effective February 3, 2013 (Supp. 12-4). Amended by exempt rulemaking at 30 A.A.R. 2045 (June 14, 2024), effective July 1, 2024 (Supp. 24-2).