The department may not consider an application complete until all of the following have been completed and submitted to the department:

1. (1) A completed application form prescribed by the department that is signed by each individual applicant or, if the applicant is an agency or corporation, by an authorized representative.

   Note: Form DCF-F-CFS0375- E, Licensing Application – Group Homes, and DCF-F-CFS0358- E, Licensing Application Checklist – Group Homes, are available in the forms section of the department’s website at https://dcf.wisconsin.gov/forms.

2. (2) A description of the target population that the group home intends to serve on a form prescribed by the department.

   Note: DCF-F-5207-E, Target Groups, is available in the forms section of the department’s website at https://dcf.wisconsin.gov/forms.

3. (3) The license fee required under s. 48.625 (2) (a), Stats.

4. (4) A background information disclosure form and written authorization for the department to make follow-up contact with the Wisconsin department of justice and any other person or organization to determine if there is any reason why the applicant should not be granted a license. A background information disclosure and authorization shall be completed and signed as follows:

   1. (a) If the applicant is one or more individuals, by each individual applicant.
   2. (b) If the applicant is a corporation or agency, by an authorized representative.
5. (5) Each applicant or authorized representative shall provide documentation that electronic fingerprints were submitted to a background check agency authorized by the department for submission to the national crime information database as required in s. 48.685 (2), Stats.
6. (6) Inspection reports verifying that the proposed group home’s physical structure and electrical, heating, and plumbing systems have been inspected and are in safe operating condition according to applicable industry standards.

7. (7) Documentation of a good faith effort to establish a community advisory committee as required under s. 48.68 (4), Stats.

   Note: DCF-F-CFS0367-E, Community Advisory Committee Documentation, is available in the forms section of the department’s website at https://dcf.wisconsin.gov/forms.

8. (8) Proof of insurance required under s. DCF 57.08.

9. (9) A copy of the group home’s policies and procedures required under this chapter.

   Note: DCF-F-CFS2378, Policy/Procedure Checklist – Group Homes, is available in the forms section of the department’s website at https:// dcf.wisconsin.gov/forms.

10. (10) If the applicant for licensure is a corporation, proof of incorporation or authorization to do business in the state, as required under s. DCF 57.465 (1).
11. (11) A proposed per client rate that each group home will charge for services provided in the current year and a proposed budget with the same cost categories as the department’s cost and service report under s. DCF 57.62 (1) (a).
12. (12) An organizational chart or a description of the supervisory structure of the group home.
13. (13) Any other information requested by the department.

History

History: CR 26-005: cr. Register May 2026 No. 845, eff. 6-1-26.