AL 101Licensing

ALH Licensing Requirements: Narrative for Jurisdiction Approval

Part of the process for licensing a residential care home is obtaining approval from your local jurisdiction that governs the property location. Sometimes this agency will require a “narrative” or written overview that describes how your business will function within the community.

The items covered in the narrative will vary from jurisdiction to jurisdiction. Generally they will ask you to address topics that may highlight an adverse impact on the community. Examples include; signage, parking, traffic flow, staffing, etc.

The jurisdiction should provide guidance and identify which topics need to be covered by the narrative. Be sure to include all items requested.

The following is an example of a narrative that I have used for licensing homes in various cities in Arizona. Please feel free to use this text and edit as needed to fulfill your requirements. There is also a link after the text to download and editable word document.

Good luck with your licensing project!

Sample Adult Care Home Overview

This document serves as a general narrative description of the proposed operation of a residential care home, known as Sample  Adult Care Home, to be located at 1234 E. Maple Dr. Anytown, AZ 85249.

General

The home will be licensed and operated within all applicable governmental rules, policies and laws including the Arizona Department of Health Services.

  • Daily operation of the residential care home will consist of staff accommodating the activities of daily living for the residents of the home. This includes, meal preparation, serving meals, serving snacks, assisting residents with bathing, hygiene, dressing, ambulation, hydration, toileting and providing social activities. The manager will also coordinate and engage additional services requested or needed by the residents. Examples include social visits, nurse evaluations, hospice care, home health care, etc.
  • Typical Schedule
    • Residents awake 6-7 am, perform ADL activities
    • Breakfast served 8:00 am
    • Social Activities / Snacks / ADL activities
    • Lunch 12:00 p.m.
    • Afternoon snacks, ADL activities
    • Dinner 5:00 pm
    • Residents retire 6:00 to 8:00 pm

Capacity

  • The function of the home will be to provide directed, personal, and supervisory care up to a maximum of 5 residents placed in the home.

Exclusivity

  • The residence will serve the needs of its residents exclusively and offer no other services except those required for the resident’s care, activities of daily living and well being.

Code Compliance

  • Inspections will be performed prior to licensing and operation to ensure the home and premises meet current building, fire safety code, and zoning and subdivision requirements of applicable agencies. Re-inspections will be done in accordance with the regulating agencies at required intervals.

Placements

  • Residents will be placed into the residential care home by; family members seeking a supervised care home, professional agencies engaged in providing placement services to clients seeking a supervised care home or other licensed healthcare institutions assisting their clients in locating a home. These can include hospitals, rehabilitation centers, or skilled nursing facilities, etc. The prospective residents will be placed in accordance with established criteria under the scope of licensing by the Arizona Department of Health Services. This process includes a medical assessment by the primary care provider, TB screening, and development of care plan to ensure services available through the care home are adequate for resident.

Staffing

  • Staffing for this home will include a state licensed manager and 2-4 caregivers depending on the number of residents and the level of care required of those residents. Staffing will be scheduled by the facility manager with at least 1 or more caregivers being present continuously to monitor and provide care for the residents. Shifts will be 12 hours, with changes at 6 am and 6 pm. Additional required services such as home health care, hospice care, etc will be scheduled as needed and provided by the appropriate licensed agencies. Transportation of staff to the home will be by private vehicle or public transportation.

Transportation

  • Transportation required by residents of the home will be provided by either; the responsible party specified in the residency agreement who acts as the president’s power of attorney and advocate during the residents stay at the home or a licensed livery service capable of providing transportation services required by the resident. Residents will not transports them or maintain a vehicle on the premises.

Parking

  • Staff will park their vehicles in the garage. The driveway will accommodate 2 additional vehicles for occasional service providers and visitors driving private vehicles to the home.

Maintenance

  • The owner of the residential home will either personally perform routine maintenance or contract maintenance services to ensure the home dwelling and exterior grounds maintain an appearance consistent with the character of the neighborhood community, the rules of the HOA and city ordinances.

Screening

  • There will not be any specific or additional outdoor recreation areas on the premises, so no additional screening will be required. Outdoor activities will be limited to normal activities of daily living (leisure and ambulation) and will occur predominantly in the backyard of the property. A masonry wall exists to provide screening for these activities.

Service Calls

  • There is no expectation that there will be any increase in service calls from the normal expectation of a typical 5 member family.

Signage

  • There will be no signage

Click to download an editable sample document

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