PURPOSE: This rule describes the procedures for application for licensure, the licensing investigation and provisions for continued licensing investigations after the initial license is granted.

1. (1) Licensing Authority.

   1. (A) Any person who desires to develop, establish, maintain or operate, or both, a residential care agency, except for those persons exempt from licensing pursuant to section 210.516, RSMo, must file an Application for Licensure form with the division and must receive a license prior to accepting any child for care.
   2. (B) Before a license may be granted, an agency must be in compliance with sections 210.481–210.536, RSMo and these rules.

2. (2) Application for Licensure.

   1. (A) An agency shall submit the following documents to the division—

      1. 1. Application for Licensure signed by

the applicant;

1. 2. Evidence of compliance with local

building and zoning requirements;

1. 3. A floor plan of the proposed site in

which the specific use of each room is identified;

1. 4. A signed copy of the Civil Rights

Agreement;

1. 5. A chart depicting the agency’s orga-

nizational structure and lines of supervision;

1. 6. Written policies and procedures

established by the board of directors which clearly set forth the authority and the responsibilities delegated to the executive director;

1. 7. A copy of the Articles of Incorpora-

tion, bylaws, and board roster, including the addresses of all officers;

1. 8. A proposed budget for a period of not

less than one (1) year;

1. 9. Verification of not less than three (3)

months’ operating capital;

1. 10. A written intake policy;
2. 11. Written identification of specific

program models or designs which shall include the methods of care and treatment to be provided;

1. 12. Job title, job description, and mini-

mum qualifications for all staff;

1. 13. A projected staffing plan for the

anticipated capacity;

1. 14. Written child abuse and neglect

reporting policy;

1. 15. Written personnel practices, includ-

ing staff training and orientation;

1. 16. Written discipline policy;
2. 17. Written visitation policy;
3. 18. Written health care policy;
4. 19. Written restraint policy which shall

include a description of all methods to be used;

1. 20. A needs assessment conducted and

submitted as evidence of need for the type and scope of program proposed. This assessment shall include, at a minimum, an identification and survey of potential referral sources, existing resources, and unmet community needs;

1. 21. Evidence of compliance with fire

safety requirements of the State Fire Marshal;

1. 22. Documentation that the agency’s

water supply and sewage disposal system is currently in compliance with the requirements of the Department of Health and Senior Services if not an approved public source;

1. 23. Verification of a physical examina-

tion for all staff working directly with children, completed by a licensed physician, certified nurse practitioner, advanced practice nurse in a collaborative practice agreement with a licensed physician, or a registered nurse who is under the supervision of a licensed physician, shall be submitted within thirty (30) days of initial licensure using the form prescribed by the division;

1. 24. Results of a check of the Family

Care Safety Registry (FCSR) for all staff, as well as students, volunteers, and contractors who have direct contact with children. Any employee who resides in another state and works in the state of Missouri, or who has relocated to the state of Missouri within the last five (5) years, shall provide documentation of child abuse/neglect and criminal background screening check(s) from those states. When an employee who lived in another state or states within the last five (5) years now resides in the state of Missouri, the documentation of child abuse/neglect and criminal background screening check(s) from the previous state(s) only needs to be completed upon initial employment. If the employee continues to reside in another state, the outof-state check shall be done annually. Results of employee medical examinations and background screenings (FCSR documentation) may be viewed by division licensing staff on site during routine record reviews;

1. 25. Verification of the education and

experience for all professional staff; and

1. 26. Written description of the recre-

ational program, and the manner in which staff are qualified and prepared to create, organize, and supervise them.

1. (3) Licensing Assessment.

   1. (A) A thorough assessment of the agency shall be made by the division, including a review of the documents required in this rule and visits to the agency to determine compliance with the licensing law and applicable rules.
   2. (B) If an applicant for licensure is determined not to be in compliance with the licensing law and applicable rules, and if compliance is not achieved within a six (6)- month period, a new Application for Licensure must be filed if the agency desires to pursue licensure.

2. (4) The License.

   1. (A) Upon determination of compliance with the licensing law and applicable rules, the director shall issue a license for an initial six (6)-month probationary term.
   2. (B) Following the probationary period, upon determination of continued compliance with Missouri statutes and applicable licensing rules, the director shall extend the term of the license for a period not to exceed two (2) years.
   3. (C) The license shall be posted in a conspicuous place on the premises of the facility.
   4. (D) The number, sex, and age range of children an agency is authorized to accept for care shall be specified on the license and shall not be exceeded.
   5. (E) The license shall not be transferable.
3. (5) License Amendment. An agency shall file an Application for Amendment with the division at least thirty (30) days prior to relocation, change in the name of the agency, change in the capacity, and/or age range of children or any major change in the program. These changes shall be approved by the division before implementation.

4. (6) Licensing Renewal.

   1. (A) An Application for Licensure shall be mailed by the division to the agency.
   2. (B) The agency shall complete and return the application to the division within thirty

5. (30) days from the date of receipt.

   1. (C) The division shall initiate action on the completed application prior to the expiration of the existing licensure period.

   2. (D) In addition to the completed application, the following documents shall be submitted:

      1. 1. Verification of a physical examination,

completed by a licensed physician, certified nurse practitioner, advanced practice nurse in a collaborative practice agreement with a licensed physician, or a registered nurse who is under the supervision of a licensed physician, for all staff working directly with children shall be submitted utilizing the form prescribed by the division;

1. 2. A current board roster, including the

addresses of all officers;

1. 3. A summary of any significant changes

to programs and copies of any resulting policies or policy changes;

1. 4. A copy of a current organizational

chart;

1. 5. Annual results of a check of the

Family Care Safety Registry (FCSR) for all staff, as well as students, volunteers, and contractors who have direct contact with children. Any employee who resides in another state and works in the state of Missouri, or who has relocated to the state of Missouri within the last five (5) years, shall provide documentation of child abuse/neglect and criminal background screening check(s) from those states. When an employee who lived in another state or states within the last five (5) years now resides in the state of Missouri, the documentation of child abuse/neglect and criminal background screening check(s) from the previous state(s) only needs to be completed upon initial employment. If the employee continues to reside in another state, the out-of-state check shall be done annually. Results of employee medical examinations and background screenings (FCSR documentation) may be viewed by division licensing staff on site during routine record reviews;

1. 6. Evidence of current compliance with

the fire and safety requirements of the State Fire Marshal;

1. 7. A record of monthly drills for fire and

emergency evacuations which are held at different times of the day and night;

1. 8. Documentation that each facility’s

water supply and sewage disposal system is currently in compliance with the requirements of the Department of Health and Senior Services if not an approved public source; and

1. 9. A copy of a financial audit conducted

by a certified public accountant not employed by the agency.

1. (E) Upon determination of compliance with the licensing law and applicable rules, the director shall issue a license for a period not to exceed two (2) years.

AUTHORITY: section 210.516, RSMo 2000.* This rule originally filed as 13 CSR 40- 71.020. Original rule filed Nov. 9, 1978, effective Feb. 11, 1979. Rescinded: Filed Oct. 13, 1982, effective Jan. 13, 1983. Emergency rule filed Nov. 1, 1993, effective Nov. 12, 1993, expired March 11, 1994. Emergency rule filed March 2, 1994, effective March 12, 1994, expired July 9, 1994. Readopted: Filed Nov. 1, 1993, effective June 6, 1994. Emergency amendment filed July 25, 2008, effective Aug. 4, 2008, expired Jan. 30, 2009. Moved to 13 CSR 35-71.020 and amended: Filed July 25, 2008, effective Jan. 30, 2009.

*Original authority: 210.506, RSMo 1982, amended 1993, 1995.