(a) Application to establish and operate a family-type home for adults shall be made on Application for Family-Type Home for Adults (DSS-2865) and filed with the commissioner of the local social services district in which the proposed home is located. The application must be signed and dated by each applicant. The date of signature shall be considered the date of application submittal.

1. (1) The following documents shall be submitted to the local department of social services in support of the application:

   1. (i) Names and addresses of former employers within the last five years and of two persons not related to the applicant(s) who are acquainted with the applicant(s)' desire and ability to operate a family-type home.
   2. (ii) A statement from a physician, signed and dated within 90 days after the date of submittal, indicating that each applicant is physically and mentally capable of providing adequate care to dependent adults. Department form Medical Evaluation (Operator) (DSS-3239) or an approved local equivalent may be used to fulfill this requirement.
   3. (iii) A statement of each applicant's education, experience and community activities.
   4. (iv) A statement of income of the applicant(s).
   5. (v) A fire inspection report, signed and dated within 90 days after the date of submittal, from the local fire department, building department, code enforcement officer or other approved local authority.
   6. (vi) A lab report which meets the standards of the New York State Department of Health, signed and dated within 90 days after the date of submittal of the quality of drinking water if a municipal water source is not available.
   7. (vii) A sketch of floor plan indicating room usage, bedroom dimensions, location of exits, and interior stairways and location of smoke detectors and fire extinguishers.
   8. (viii) The name, address and qualifications of the proposed substitute caretaker(s).
   9. (ix) For substitute caretakers who are scheduled to provide 20 or more hours of care a week, a statement from a physician, signed and dated within 90 days after submittal, indicating that the individual is physically and mentally capable of providing adequate care to dependent adults. Medical Evaluation (Operator) (DSS-3239) or approved local equivalent may be used to fulfill this requirement.

2. (2) Documents shall be submitted to the local department of social services necessary to check with the Register of Substantiated Category One Cases of Abuse or Neglect (staff exclusion list) maintained by Vulnerable Persons’ Central Register (VPCR) and the Statewide Central Register of Child Abuse and Maltreatment of the Office of Children and Family Services whether the applicant or any person 18 years of age or older who resides in the home of the applicant is the subject of an indicated child abuse or maltreatment report on file with the Statewide Central Register of Child Abuse and Maltreatment or a substantiated report on file with the VPCR.

   (c) Time frame.

3. (1) All supporting documentation required to complete the application must be submitted to the social services district within 120 days after the date of the submittal. Failure to submit any required supportive documents within the prescribed time periods may be grounds for denial of the application.
4. (2) The social services district must submit the application form, along with a recommendation on public need, the character, competence and financial viability of the applicant, supporting documentation, and a Survey Report—Family-Type Home for Adults (DSS-2867) conducted within 45 days after the date of submittal along with a recommendation on approval or disapproval of the application to the department within 45 days of receipt of a completed application.

(b) Supporting information.

(e) The department shall issue an operating certificate to all approved family-type home operators. Such certificates shall be subject to the requirements of section 485.5 of this Title.

1. (1) The department shall notify the operator and the local department of social services 90 days before the expiration of the operating certificate.
2. (2) Within 60 days after the receipt of such notification, the operator must submit the completed application for renewal and the documents described in subparagraphs (b)(1)(ii), (iv), (v), (vi) and (ix) of this section to the social services district in support of the application.

3. (3) At least 15 days prior to the expiration date of the operating certificate, the social services district must submit the application for renewal form, supporting documentation and a Survey Report Family-Type Home for Adults (DSS-2867) completed within six months of the expiration date of the certificate along with a recommendation of approval or disapproval of the application to the department.

   (g) Denial or revocation.

4. (1) If the department determines that an application for an initial or renewal operating certificate should not be approved or that an operating certificate should be revoked, limited or otherwise modified because of noncompliance with the requirements of this Part, the department shall give notice to the local district and the operator and advise the operator of the availability of a hearing in accord with Part 343 of this Title.

   (h) Voluntary closure.

5. (1) In the event that an operator elects to close a family-type home and to surrender an operating certificate, written notice, including a plan for closure, must be given to the local department of social services at least 120 days before the expected closing date. Such action must be in accordance with the requirements of subdivision (j) of section 485.5 of this Title.

   (i) Dual certification.

6. (1) A facility licensed or certified by another State agency to provide long term residential care to dependent adults may not be certified as a family-type home for adults.
7. (2) A certified family-type home for adults may not be certified or licensed by another State agency to provide long term residential care to dependent adults.

8. (3) A person who is certified as a foster parent for a child also may be certified as an operator of a family-type home for adults in order to provide care for a former foster child who is over age 21, but remains in need of personal care and supervision because of a disability, provided that:

   1. (i) the former foster child meets the admission standards as set forth in section 489.7 of this Part;
   2. (ii) the home complies with the appropriate operating provisions of this Part;
   3. (iii) the social services district ensures that the appropriate district staff are aware of the continued placement of the individual in the home, that such staff have assessed the impact on any remaining foster children in the home and have approved of the situation; and
   4. (iv) unless a waiver of this subparagraph is issued, the family-type home operating certificate will permit only one former foster child to be cared for in the home at one time and will expire when the former foster child moves out of the home.

(f) Renewal.