1. (a) the name of the residential program;
2. (b) the type of residential program for victims of domestic violence which the applicant seeks to operate;
3. (c) with the exception of safe home networks, safe homes, domestic violence sponsoring agencies, and safe dwellings, evidence of inspection and approval from applicable local authorities and officials, regarding compliance with health, sanitation, fire safety and building code requirements;

4. (d) the name and address of the not-for-profit organization operating the residential program, and, where applicable, either:

   1. (1) a copy of the articles of association and proof of Federal tax-exempt status; or
   2. (2) a copy of the certificate of incorporation and verification of filing with the Department of State for incorporation;

5. (e) satisfactory evidence of finances sufficient to operate properly and in accordance with this Part, including:

   1. (1) a projected annual budget showing anticipated operating expenses and income; and
   2. (2) a copy of the most recent financial report prepared by a certified public accountant or most recent State and Federal tax returns of the applicant organization. If an organization has been in existence for less than one year and if neither are available, a statement of the organization's assets and liabilities, signed by an officer of the organization;

6. (f) a description of the residential program and services which must include the following:

   1. (1) a description of how the required emergency core services for the particular program will be delivered, the methods by which persons will gain access to the program, intake procedures for persons in need of temporary shelter, and rules regarding length of stay for persons receiving temporary shelter;
   2. (2) a description of community support and efforts to establish community linkages with police, family courts, local social services district, other domestic violence programs, local animal welfare organizations, and other community agencies;
   3. (3) a copy of the resident’s rights and responsibilities, and the program’s responsibilities;
   4. (4) a plan for the safety and security of residents and a statement indicating the extent to which the site location is known to the general public;
   5. (5) a description of disaster and emergency plans which must include provision for obtaining emergency medical care;
   6. (6) a description of available meal provisions;
   7. (7) with the exception of safe home networks and domestic violence sponsoring agencies, a description of the method and frequency of fire drills; and
   8. (8) any other information required by the office to further the purposes of this Part;

7. (g) a description of staffing which must include:

   1. (1) copies of all policies showing compliance with the requirements of section 452.11 of this Part;
   2. (2) a description of the pattern of supervision of staff by the director or other responsible person, schedule and content of training and use of training resources (such as other agencies, conferences, college courses); and
   3. (3) a sample of all forms used by the program including admission forms, resident’s rights and responsibilities, and program responsibilities; and

8. (h) with the exception of safe home networks and domestic violence sponsoring agencies, a description of the proposed or actual facility site, including its location, construction characteristics, use of the building for purposes other than the provision of services to victims of domestic violence and a diagrammatic floor plan of the entire facility.

   1. (1) The diagram must be labeled with the planned use of all program areas, and must indicate plumbing fixtures, such as toilets, sinks and bathtubs and/or showers and the means of egress.
   2. (2) The diagram must also reflect the facility's security plan.
   3. (3) A facility may not expand its services or increase its capacity unless it has received prior written approval of the office and has complied with all applicable office regulations.

The completed application to the office must include the following: