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1. Click ‘Get Form’ to open it in the editor.
2. Begin by filling out the Facility Information section. Provide the name, address, and contact details of your facility. Ensure accuracy to avoid processing delays.
3. Next, complete the Facility Administrator Information. Include the administrator's name, birth date, and contact information.
4. In the Resident Information section, indicate total resident capacity and check applicable client groups you intend to serve.
5. Fill out the Licensee Information by selecting your ownership type and providing relevant details about yourself or your organization.
6. Complete the Fit and Qualified section by answering questions regarding previous licenses or certifications held.
7. Finally, provide Monthly Fees and Operating Expenses. Ensure all financial information is accurate and supported by documentation.

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