77 Ill. Adm. Code 295.500
Application for License
Section 295
Section 295.500Â Application
for License
a)
An
applicant
shall provide the following
information,
on forms provided by
the Department, to be considered for
licensure:
1)
The business name, street address, mailing address, and
telephone number of the establishment;
2)
The name and mailing address of the owner or owners of the
establishment and, if the owner or owners are not natural persons,
identification of the type of business entity of the owners, and the names and
addresses of the officers and members of the governing body, or comparable
persons for partnerships, limited liability companies, or other types of
business organizations;
3)
Financial information establishing that the project is
financially feasible,
in one of the following forms:
A)Â Â Â Â Â Â Â A surety bond in an amount equal to at least three months
operating expenses;
B)Â Â Â Â Â Â Â An independent certified public accountant's report expressing
an opinion on the financial status of the establishment;
C)Â Â Â Â Â Â Â An audited financial report certifying the financial status of
the applicant;
D)Â Â Â Â Â Â Â The entity's most recent bond rating (less than two years old)
from Fitch's, Moody's, or Standard and Poor's rating agency that documents an
"A" rating or better;
E)Â Â Â Â Â Â Â Evidence of operation for at least two years of a facility
licensed under the Nursing Home Care Act, the MC/DD Act, ID/DD Community Care
Act, or the Assisted Living and Shared Housing Act; or
F)Â Â Â Â Â Â Â Â If the applicant is not able to provide any of the information
listed in subsections (a)(3)(A)-(E), the applicant may provide any other
information acceptable to the Department that demonstrates financial status.
4)
The name and mailing address of the managing agent of the
establishment, whether hired under a management agreement or lease agreement,
if different from the owner or owners, and the name of the full‑time
director
of the establishment
;
5)
Verification that the establishment has entered or will
enter into a service delivery contract as provided in Section
295.2030,
as
required under
the
Act, with each resident or resident's representative;
6)
The name and address of at least one natural person who
shall be responsible for dealing with the Department on all matters provided
for in
the
Act
and this Part,
on whom personal service of all
notices and orders shall be made, and who shall be authorized to accept service
on behalf of the owner or owners and the managing agent. Notwithstanding a
contrary provision of the Code of Civil Procedure, personal service on the
person identified pursuant to this subsection
(a)(6)
shall be considered
service on the owner or owners and the managing agent, and it shall not be a
defense to any action that personal service was not made on each individual or
entity;
7)
The signature of the authorized representative of the owner
or owners;
8)
Proof of an ongoing quality improvement program in
accordance with
Section 295.2060;
9)
Information about the number and types of units and the
maximum census;
10)
Information about the
mandatory and optional
services
to be provided at the establishment;
11)
Proof of compliance with applicable State and local
residential standards
, as evidenced by completion of the Department's Code
Certification of Compliance form;
12)
A copy of the standard contract offered to residents;
13)
Documentation of adequate liability insurance;
(Section
30 of the Act)
14)Â Â Â Â Â Â Â Â A completed Alzheimer's Disease and Related Dementias Special
Care Disclosure form; and
15)Â Â Â Â Â Â Â Â A schematic drawing of the establishment.
b)Â Â Â Â Â Â Â Â The
application shall indicate a request for either standard licensure or floating
licensure. An application for a floating license shall comply with Section 32
of the Act and Section 295.1110.
c)Â Â Â Â Â Â Â Â If
all units are not licensed, the establishment shall maintain documentation of
which units are providing assisted living services. This number shall not
exceed the number of units on the license. The entire building having any
licensed units shall meet the physical plant requirements of this Part.
d)Â Â Â Â Â Â Â Â If
the establishment does not have a permit under the Life Care Facilities Act and
the establishment requires entrance or application fees in excess of three
months of a resident's minimum fees, the establishment shall maintain a bond or
restricted account that guarantees the return of the resident's entrance fees
or the unused portion of his or her deposit if the establishment ceases to
operate.
e)Â Â Â Â Â Â Â Â To support regulatory activities necessary to implement the
Act, applications shall be accompanied by a nonrefundable fee of:
1)Â Â Â Â Â Â Â Â $2,000 for an assisted living establishment and $20 per licensed
unit; or
2)Â Â Â Â Â Â Â Â $1,000 for a shared housing establishment.
f)Â Â Â Â Â Â Â Â If
any of the information in the application changes during the application
process, the applicant shall notify the Department, in writing, of those
changes. The written notification will become a part of the licensee's file.