Here you will learn how to apply for a state license to provide residential services for children and adolescents who have – or who are at risk of – mental illness, serious emotional disturbance, substance use disorders, intellectual disabilities, or brain injury. DBHDS is responsible for licensing residential facilities that serve these children and adolescents on site.
(Please click here if you are applying for a license to provide any other service than children's residential.)
REQUIREMENTS FOR A LICENSE
To be licensed by DBHDS to provide children's residential services, the applicant must:
- Submit and receive preliminary approval of the Initial Provider Application (and required attachments).
- Submit, receive approval of, and demonstrate knowledge of required licensing policies, procedures and forms.
- Submit and receive approval of required Human Rights Policies and Procedures.
- Develop policies that are in compliance with The Rules and Regulations to Assure the Rights of Individuals receiving services from Providers Licensed, Funded or Operated by the Department of Behavioral Health and Developmental Services, which can be found at Human Rights Regulations.
- Complete the "Human Rights Compliance Verification Checklist", which can be found at Human Rights Verification Checklist. The Applicant must submit the Compliance Verification Checklist and their Complaint Resolution Policy to firstname.lastname@example.org.
* Within 5 working days of receipt of the "Human Rights Verification Checklist", the Office of Human Rights will notify the Applicant of the status of the Applicant's Complaint Resolution Policy. If approved, the Applicant will be referred via email to an assigned advocate. If not approved, guidance for compliance will be provided.
* The Applicant's assigned advocate will assign the Applicant to a local Human Rights Committee (LHRC). The Human Rights advocate will schedule a visit to the program within 30 days of the initial license to review the Applicant's Human Rights policies for compliance and provide training on CHRIS reporting.
- Register with the Department of Social Services Office of Background Investigations (DSS OBI). (When notified that the applicant is fully licensed, request criminal history and central registry background investigations for identified staff as required by Virginia Code §37.2-408.1, and submit Child Protective Services reference checks.)
- Undergo an on-site review of the physical plant, including interviews about the provider’s service description, policies and procedures. Applicants will demonstrate compliance with regulations and present copies of forms, and sample client and personnel records.
INITIAL PROVIDER LICENSING APPLICATION
The Initial Provider Licensing Application packet is for new applicants interested in becoming providers of children's and adolescents' residential services. In the packet, the applicant will find forms and information needed to successfully apply for a license and manage your program. Obtain your initial application packet in one of two ways:
- Download for free the Initial Provider Application packet documents, or
- Mail your complete order form and your organization check or money order in the amount of $35.00 made out to "Treasurer of Virginia." A helpful training DVD is included with your order. See "Fees" below.
Initial Provider Application Packet- (Download the entire packet or click on the following individual forms as needed)
There is an Initial Application Fee for applicants interested in becoming providers of children's and adolescents' residential services. Please mail your completed Initial Provider Application form with your organization check or money order in the amount of $500.00 made out to "Treasurer of Virginia". (see below for details)
New Applicant Training is strongly encouraged prior to submitting your application.
Renewal application - Please use this form to renew an existing license to provide children's residential services. Please mail your completed Renewal Application form with your organization check or money order in the amount of $100.00 made out to "Treasurer of Virginia".
Attention: Office of Licensing
P.O. Box 1797
Richmond, VA 23218-1797
Service Modification of License
Service Modification Application - Please use this form when you are already licensed to provide children's residential services and want to want to modify the license or add a service or location. Please submit the completed form 30-60 days prior to implementation of the modification.
Regulatory Code, Process and Standards specific to Children's Residential Services were revised effective January 1, 2009:
The Department can only accept payments in the form of your organization check or money order, made out to "Treasurer of Virginia". The following licensing services are available to providers and provider-applicants:
There is a $35.00 fee if you opt to receive the Initial Provider Application packet through the mail or choose to download the packet for free.
Training DVD for children’s residential services is $75.00.
The fee is $500.00 for the Initial Application for providers of children's residential services, due when you submit your completed application form.
There is a Renewal Fee of $100.00 for renewal of a license to provide children's residential services.
Please mail the completed order form with your Organization CHECK or MONEY ORDER, made out to "Treasurer of Virginia", to the following address. If you have any questions, you may phone (804) 786-9302. Thank you.
DBHDS, Office of Licensing
Attention: Stella Stith, Office of Licensing
P.O. Box 1797
Richmond, VA 23218-1797