The following must be submitted by the applicant with the initial application:
Plans of the ICF/MR, drawn to scale, showing the use of each room and the source of utilities and methods of waste disposal.
A written statement, signed by an authorized representative of the Division of Environmental Health of the Department, indicating compliance of the facility with all applicable State statutes and regulations relating to plumbing, water supply, and sewage disposal.
A written statement, signed by the appropriate local Regional Management Team of the Office of Adults with Cognitive and Physical Disabilities Services of the Department, indicating the ICF/MR's stated philosophy, operating policies and procedures, staffing pattern, physical plant design and day programming, and upholding the rights of persons with mental retardation, as set forth in Title 34-B M.R.S.A., subsection5601et seq.
A copy of the policies governing the services of the facility must be submitted to the Department. The Department shall notify the facility in writing of any policies which are not approved due to noncompliance with any statutes or regulations.
Each applicant shall have an agreement with a licensed hospital concerning the transfer of clients.
When a building is leased, a copy of the lease must be filed with the application for a license. The lease shall clearly indicate responsibility for the maintenance and upkeep of the property. The Department shall be notified within seventy-two (72) hours if there is any change in the lease agreement that may, in any way, affect the responsibility for maintenance and upkeep of the property.
A letter from the appropriate municipal official having jurisdiction over the premises where the facility is to be located, indicating compliance with all local laws relative to the type of facility for which the license is requested must be on file in the facility.
10-144 C.M.R. ch. 118, § 3.C