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INSTRUCTIONS FOR ADULT DAY CENTER APPLICATIONS

INSTRUCTIONS FOR ADULT DAY CENTER APPLICATIONS The governing body of each ADULT day CENTER shall submit a completed application for a license on forms provided by the Department of Community Health. A separate application and license is required for each ADULT day CENTER located at different premises. A mobile ADULT day CENTER can include no more than five (5) off-site locations per application and license. 1. The application form shall be accompanied by the following: a. Proof of the legal right to occupy the property where the ADULT day CENTER is housed; b. Proof of ownership or right of occupancy shall include a warranty deed, lease agreement or bill of sale; or written permission from the owner of the premises authorizing the ADULT day CENTER to operate exclusively within a designated space is permissible where the ADULT day c

Church Government Other 6. Registered Agent for Service (for Corporation) ... Policies and Procedures and Disaster Plan Procedures will be reviewed on-site Submission of the application is subject to approval by the Department. ... ADC DISASTER PREPAREDNESS PLAN REVIEW FORM Center: _____ Date: _____ ...

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