License a Family Care Home (2-6 Beds)

This procedure outlines the steps to license a new family care home in North Carolina. Family care homes are licensed under General Statute 131D. The N.C. Medical Care Commission has rulemaking authority. Rules are found in Title 10A of the North Carolina Administrative Code (NCAC): 10A NCAC 13G.

Contacts: Initial contact for licensing a family care home (FCH) should be made with the adult services section of the local county department of social services. An adult home specialist with that agency will provide licensing information to the applicant and collect the necessary licensure materials from the applicant to be sent to the N.C. Division of Health Service Regulation to complete the licensure process. For questions regarding this process, please contact the local county department of social services or the appropriate section of the N.C. Division of Health Service Regulation.

Adult Care Licensure Section 919-855-3765
Construction Section 919-855-3893
County Department of Social Services - Adult Services Section Refer to local phone directory

Procedures:

  1. Apply for a license: County Department of Social Services (DSS)
    1. The prospective applicant for family care home licensure contacts the county adult home specialist in the social services department of the county where the facility is to be located.
    2. The adult home specialist responds to all inquiries regarding license applications for family care homes. At a minimum, the initial interview between the adult home specialist and the prospective applicant or his/her authorized representative includes the following:
      • A general review of the licensure rules and the licensing process as outlined in this document.
      • Referral of the applicant to the local zoning board to assure zoning approval(s)
      • Referral of the applicant to the Adult Care Licensure section to request an application packet and rulebook.
      *Directing the applicant to submit all information/material required for licensure described in this document to the adult home specialist who is responsible for submitting it to the Adult Care Licensure section.
    3. If the prospective applicant decides to apply for a license, the adult home specialist will direct the applicant to complete and submit to the specialist the Initial License Application (PDF, 87 KB) which must accompany the material submitted to the Construction section as specified in Section 2 below.
    4. The following information for administrator approval needs to be submitted to the adult home specialist as soon as possible to avoid delay in licensing. The specialist will forward this information to the Adult Care Licensure section with a cover letter requesting administrator approval.
      • Report of administrator qualifications (in FCH application packet)
      • Documentation of completion of 30-day on-the-job training or a notice of exemption from the training from the Adult Care Licensure section. If applicant administrator believes he/she has education, training and experience related to the management and operation of adult residential care facilities, a letter requesting Administrator-In-Training exemption and specifying reason for request should be sent to the Adult Care Licensure section as soon as possible in the application process.
      • Documentation of local criminal background check
      • Three current reference letters including at least one former employer
      • Documentation of tuberculosis screening
      • Documentation of passing state administered rules exam
      • Documentation of completion of high school or GED program
    5. Upon receiving the application material from the adult home specialist, the Adult Care Licensure section sends a letter to the applicant requesting submission of certain records, policies and procedures for review.
  2. Obtain construction approval: Construction Section
    1. An initial assessment is made by the adult home specialist of existing structures proposed for housing six or fewer residents to identify any major obstacles to licensure. The adult home specialist verifies that the location is approved by the local zoning office, before proceeding to the next step. The initial licensure application and approval letter from the local zoning jurisdiction must be submitted by the adult home specialist with the information required for construction approval as specified below.
    2. The adult home specialist, if necessary, may consult with the Construction section for advice and/or assistance regarding the need to inspect an existing structure proposed for use as a family care home.
    3. For existing structures, the adult home specialist writes a cover letter or transmittal form to the Adult Care Licensure section of the Division of Health Service Regulation identifying the prospective home site address and location, the name of the contact person including an address, telephone number and fax number (if available), the applicant name and address (if not the same as the contact person), the local building inspector's and fire marshal's office telephone numbers, the proposed resident capacity of the home, and what the applicant expects the evacuation capability of the residents to be. A 1/4-inch per foot scaled drawing (house plan) and color photo prints showing pictures of all exterior sides of the building and yards and each interior room shall be submitted with the application.
    4. For new construction, the applicant provides schematic floor plans or blueprints as follows: For family care homes, the applicant submits a 1/4-inch per foot scaled drawing (house plans) to the Adult Care Licensure section for processing in accordance with licensure rules 10A NCAC 13G. In the cover letter or transmittal form, the applicant identifies the prospective home site address and location, the name of the contact person including an address, telephone number, and fax number (if available), the applicant's name and address (if not the same as the contact person), the proposed number of residents, the local building inspector's and fire marshal's office telephone numbers, and what the applicant expects the evacuation capability of the residents to be.
    5. The Construction section reviews plans and other construction related information for all types of family care homes and sends the applicant a memorandum of review noting any requirements for the facility to complete in order to comply with construction and/or fire safety related licensure rules. The Construction section will invoice the applicant the cost of the review. Projects will not be reviewed until the invoice is paid in full by returning a copy of the invoice with check or money order made payable to Division of Health Service Regulation. The check or money order (with copy of invoice attached or invoice number written on the check) for plan review should be mailed to: Construction Section; 2705 Mail Service Center; Raleigh, NC 26699-2705.
    6. Once the home has completed renovations or new construction, the applicant sends the Construction section copies of approval documents from the local building inspector, fire marshal, and sanitarian and any other documents requested by the plan reviewer. After all required documents are reviewed and approved and an on-site inspection is satisfactorily completed by the Construction section, the Construction section sends a building transmittal form showing allowable bed capacity and resident evacuation capability and any building related restrictions to the Adult Care Licensure section for processing. Upon receipt of the Construction section's approval letter, the applicant contacts the local adult home specialist in their local county DSS office for the next step in the licensing process.
  3. Compilation of Records: County Department of Social Services
    1. The adult home specialist meets with the applicant or designee to discuss the operational plans and policies necessary for licensure. During these contacts, the applicant supplies information to document that personnel requirements for the administrator are met and that the applicant has an adequate plan to operate according to licensure rules.
    2. The adult home specialist assesses the applicant's operational plan. Specific emphasis is to be placed on staffing patterns and the responsibility of each staff member, implementation of the family care home Residents' Bill of Rights, the admission and discharge policies, the services and accommodation requirements, life safety requirements and other policies and procedures of the home.
    3. The adult home specialist documents that the personnel requirements for all staff are met by reviewing the home's personnel records.
    4. The adult home specialist reviews with the applicant or designee the duties and responsibilities associated with civil rights compliance, ensures the completion of the necessary documents and submits the documents to the N.C. Division of Aging and Adult Services.
    5. Once the adult home specialist has determined the applicant's readiness to be licensed, the adult home specialist submits the initial license application and documentation of administrator approval to the Adult Care Licensure section and requests the applicant to submit the required licensure fee to the Adult Care Licensure section. The application will not be processed until receipt of the fee.
  4. Obtain a license: Adult Care Licensure Section
    1. Upon the receipt of the application material from the adult home specialist, the Adult Care Licensure section reviews it and contacts the adult home specialist and/or the applicant for additional information if needed.
    2. The adult home specialist monitors the progress of the applicant in completing all needed items to ensure the home meets licensure requirements and makes an on-site visit to the home to ensure it is ready to be licensed.
    3. If there is any incomplete information or if there are findings on the compliance history check prohibiting licensure according to G.S. 131D-2.4, the Adult Care Licensure section notifies the applicant in writing and requests, as appropriate, changes or necessary information.
    4. With Construction section's recommendation for licensure, the Adult Care Licensure section (ACLS) issues the license with a cover letter to the applicant. The county DSS will receive a copy of the cover letter and license from the ACLS office.
    5. Initial licenses are issued for a six (6) month period. An inspection or licensure survey by ACLS is required to ensure compliance with the regulations (10A NCAC 13G) for continued licensure. If the facility does not have any residents during this time, and ACLS cannot ascertain compliance, then the licensee would have to reapply for an initial license.
    6. Licenses must be renewed annually using the Renewal License Application for Family Care Homes and submission of the $315 renewal license fee.