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Minnesota Administrative Rules

9555.5515 RECORD ON THE RESIDENCE.

A record for the residence licensed as an adult foster home shall be maintained by the commissioner and contain:

A.

a copy of the completed licensing application form signed by the applicant and the representative of the commissioner, as specified in part 9555.6115, subpart 1;

B.

the physician's reports on caregivers and household members specified in part 9555.6125 if the operator is an individual;

C.

the initial and subsequent inspection report from the fire marshal specified in part 9555.6125 and the subsequent home safety checklists;

D.

any written inspection reports from a health authority or building official;

E.

the commissioner's initial and any renewal licensing studies and inspections;

F.

any comments of the operator or provider about the licensing studies and inspections;

G.

written references from at least three persons who know about the applicant's potential to operate an adult foster home. If the applicant has been licensed through another jurisdiction, the local agency shall also request and keep a reference from the licensing authority in that jurisdiction;

H.

a list of residents currently in the residence;

I.

a list of residents who have been in the residence in the past five years;

J.

documentation of any variances to parts 9555.6105 to 9555.6265;

K.

arrest, conviction, and criminal history records on the operator, caregivers, and household members;

L.

if the operator is a partnership, corporation, or governmental unit, the information required in part 9555.6125, subpart 3, item C, subitems (1), (2), (3), (6), and (7);

M.

a copy of the commissioner approved, written adult foster home program required in part 9555.6235;

N.

a record of any substantiated complaints of maltreatment as defined in Minnesota Statutes, section 626.5572, subdivision 15, and any corrective action taken under parts 9555.7100 to 9555.7600; and

O.

a copy of the facility abuse prevention plan required under the Vulnerable Adults Act.

Statutory Authority:

MS s 14.386; 14.388; 256.01; 256E.03; 256E.05; 256E.08; 393.07

History:

12 SR 148; 30 SR 585; L 2012 c 216 art 9 s 38

Published Electronically:

December 3, 2012

700 State Office Building, 100 Rev. Dr. Martin Luther King Jr. Blvd., St. Paul, MN 55155 ♦ Phone: (651) 296-2868 ♦ TTY: 1-800-627-3529 ♦ Fax: (651) 296-0569