Reporting Requirements for Change in Administrator

In response to CALA’s request for clarification regarding reporting requirements for change in administrator, DSS released the following: 

The reporting requirements section of the regulations states the licensee shall notify the Department, in writing, within thirty (30) days of the hiring of a new administrator. The notification shall include the following: 1) Name and residence and mailing addresses of the new administrator; 2) Date he/she assumed his/her position; and 3) Description of his/her background and qualifications, including documentation of required education and administrator certification, a photocopy of the documentation is acceptable. In addition to the written notification the following documentation is required:

• LIC 308 Designation of Administrative Responsibility

• LIC 500 Personnel Report specifying the administrator’ work hours

• LIC 501 Personnel Record

• Copy of the Administrator Certificate (applicable to Adult Residential & Residential Care Facilities for the Elderly)

• A criminal record clearance that is associated to the facility where they will be working. This is required prior to the administrator.s employment or presence in the facility (Licensees can use the LIC 9182 to request a criminal record clearance transfer). Please note that if the administrator has previously been granted a criminal record exemption to work, you must use the LIC 9188 to request a transfer of the criminal record exemption transfer.

• For corporate licensees, a copy of the board resolution. If not available at the time of the change, the written notification must include the date of the next board meeting and the resolution must be sent to the licensing office after the board adopts the resolution.