TITLE 18. PROFESSIONAL AND OCCUPATIONAL LICENSING
REGISTRAR'S NOTICE: Forms used in administering the regulation have been filed by the agency. The forms are not being published; however, online users of this issue of the Virginia Register of Regulations may click on the name of a form with a hyperlink to access it. The forms are also available from the agency contact or may be viewed at the Office of the Registrar of Regulations, 900 East Main Street, 11th Floor, Richmond, Virginia 23219.
Title of Regulation: 18VAC95-30. Regulations Governing the Practice of Assisted Living Facility Administrators.
Agency Contact: Elaine Yeatts, Agency Regulatory Coordinator, Department of Health Professions, 9960 Mayland Drive, Henrico, VA 23233, telephone (804) 367-4688, FAX (804) 527-4434, or email elaine.yeatts@dhp.virginia.gov.
FORMS (18VAC95-30)
Assisted Living Facility Administrator Application for Licensure - form available online only at https://www.dhp.virginia.gov/nha/nha_forms.htm#alfa
Assisted Living Facility Administrators Education and Experience Matrix (rev. 3/2019)
Assisted Living Facility Administrators Education and Experience Matrix (rev. 7/2020)
Assisted Living Facility Administrator Administrator-in-Training Application - form available online only at https://www.dhp.virginia.gov/nha/nha_forms.htm#alfa https://www.license.dhp.virginia.gov/apply/
Monthly Report of Assisted Living Facility Administrator-in-Training (rev. 3/2019)
Assisted Living Facility Administrator-in-Training Documentation of Completion Form (rev. 3/2019)
Assisted Living Facility Administrator-in-Training Notice of Change of Status or Discontinuance (rev. 3/2019)
Monthly Report of Assisted Living Facility Administrator-in-Training (rev. 7/2020)
Assisted Living Facility Administrator-in-Training Documentation of Completion Form (rev. 7/2020)
Assisted Living Facility Administrator-in-Training Notice of Change of Status or Discontinuance (rev. 7/2020)
Assisted Living Facility Administrator Preceptor Application - form only available online at https://www.dhp.virginia.gov/nha/nha_forms.htm#alfa
Proposed AIT Training Plan Domains of Practice (rev. 3/2019)
Checklist and Instructions for Assisted Living Facility Administrator Reinstatement Application (rev. 3/2019)
Checklist and Instructions for Assisted Living Facility Administrator Preceptor Reinstatement Application (rev. 3/2019)
Checklist and Instructions for Acting Assisted Living Facility Administrator-in-Training (rev. 3/2019)
Proposed AIT Program Training Plan Domains of Practice (rev. 7/2020)
Checklist and Instructions for Assisted Living Facility Administrator Reinstatement Application (rev. 7/2020)
Checklist and Instructions for Assisted Living Facility Administrator Preceptor Reinstatement Application (rev. 7/2020)
Checklist and Instructions for Acting Assisted Living Facility Administrator-in-Training (rev. 7/2020)
Continuing Competency Activity and Assessment Form for Assisted Living Facility Administrators (rev. 9/2010)
Continuing Education (CE) Credit Form for Volunteer Practice (eff. 2/2018)
Name/Address Change Form (rev. 3/2019)
Request for Verification of Virginia NHA or ALFA License (eff. 3/2019)
Continuing Education (CE) Credit Form for Volunteer Practice (rev. 7/2020)
Name/Address Change Form (rev. 1/2021)
Request for Verification of Virginia Long-Term Care Administrators License (rev. 11/2019)
VA.R. Doc. No. R21-6633; Filed January 05, 2021