Your application will be processed by an intake licensor. The intake licensor will assist you in gathering and submitting the necessary paperwork for licensure including:

1. A policy and procedure manual outlining how you will comply with General Provisions (Utah Code R501-1) and your license category rules
2. Copy of your business license
3. Verification of fire inspection
4. Verification of health inspection, if required by your local jurisdiction
5. Verification of insurance (general/professional liability, fire, vehicle)
6. An organization chart of your agency indicating lines of authority, position titles, job descriptions, etc.
7. A list of members of your governing body including owners and board of directors indicating name, address and term of membership (may be part of your policy and procedure manual)
8. Your quality assurance plan (may be part of your policy and procedure manual)
9. Your emergency plan (may be part of your policy and procedure manual)

Additional paperwork may be required depending on the category of license you are applying for (e.g. floor plans, school accreditation certificate, proof of notification to your local government jurisdiction, etc.) Paperwork can be submitted to the intake licensor by email at the time of your application (preferred) or you can send in a hard copy with your application and fee.

Background screenings should be done in the Direct Access Clearance System (DACS) for all staff who will have direct or incidental contact with clients or their records. Brand-new programs will be given access to DACS after submitting a license application.

Adult-only substance abuse programs may request an exemption from this for general staff if other types of treatment (such as mental health treatment) are not provided by submitting this form. Owners and directors who will have direct access to clients and their records must still submit a screening application.

More information on the process of background screenings can be found here.

Once all paperwork has been submitted, your application will be assigned to a licensor who will review your policies and procedures, do a safety inspection of your location and address any outstanding concerns.

The licensor will issue your license when all criteria have been met.

To help you prepare for this process, you can find an appropriate checklist here.

Along with the application, you will need to submit the appropriate Residential or Non-Residential HCBS Waiver Attestation form and Self-Assessment Survey. These are attached to the certification application, and can also be downloaded from the state Medicaid website here.

Your application will be forwarded to the Licensing Supervisor over your area and assigned to a licensor. The licensor will do a safety inspection and issue your certification.

To help you prepare for this, you can find the certification inspection checklist here.

• Relocation of a currently-licensed program requires a new renewal application and fee 30 days prior to the move, even if your current license has not expired. Relocating a currently-licensed program without notifying the Office of Licensing will void your license, requiring a new initial application and fee
• Changing capacity of a currently-licensed program requires a new renewal application and fee even if your current license has not expired
• Adding a new license category to a currently-licensed location (for example, adding Outpatient Treatment to your current Day Treatment program) requires an initial application and fee for the new license category
• Adding a new location (rather than relocating) requires an initial application and fee
• A name change of your program does not require a new application or fee but your licensor should be notified at least 10 days prior to the change
• An ownership change of your program should be communicated to the Office of Licensing as soon as possible prior to the change. A substantial change to your program as defined in General Provisions will require a new initial application