Section 101. Application For Certification

The applicant must apply for certification on Department forms and submit the following to the Department: (3-28-23) 01. Completed Application Signed by Applicant. (3-28-23) 02. Statement to Comply. A written statement that the applicant has thoroughly read and reviewed al l CFH requirements, and is prepared to comply. (3-28-23) 03. Statement Disclosing Revocation or Disciplinary Actions. A written statement disclosing any past, current, or pending revocation, or other disciplinary action, against the applicant as a care provider in any jurisdiction. (3-28-23) 04. Electrical Inspection. A written statement from a licensed electrician or the local/state electrica l inspector within the past twelve (12) months indicating that all electrical installations in the home comply with applicable local code and are in good working order. (3-28-23) 05. Plumbing Inspection. A written statement from a licensed plumber within the last twelve (12 ) months that the water supply and sewage disposal system in the home are in good working order. (3-28-23) 06. Heating and Air Conditioning Inspection. A written statement within the last twelve (12) month s by a person licensed to service heating and cooling systems that these systems in the applicant's home are in goo d operating condition. (3-28-23) 07. Proof of Insurance. Proof of homeowner's or renter's insurance on the applicant’s home. Fo r continued certification, the provider must ensure that insurance is kept current. (3-28-23) 08. List of Individuals Living in the Home. A list of all individuals living in the home at the time o f application and their relationship to the applicant. (3-28-23) 09. Other Information as Requested. Other information that may be requested by the Department fo r the proper administration and enforcement of the CFH requirements. (3-28-23)