Frequently Asked Questions

New construction requires approval from the Department of Health, Construction Review Services (DOH-CRS). Contact DOH-CRS for review of all new assisted living facility construction. The application is available at https://doh.wa.gov/licenses-permits-and-certificates/facilities-z/construction-review-services-crs. Write to: Department of Health, Construction Review Services, P.O. Box 47852, Olympia, WA 98504-7852. Phone: (360) 236-2944. Fax: (360) 236-2901. Email: fslcrs@doh.wa.gov. CRS approval must be obtained before an assisted living facility license can be issued. The assisted living facility application may be submitted prior to obtaining CRS approval.

You will need to fill out and submit a completed Change of Licensee (Operator) “Mini” application.

If you do not know which Change of Licensee (Operator) application to use, call the Business Analysis and Application Unit at (360) 725-2420.

If you do not currently operate a licensed assisted living facility in the State of Washington, fill out and submit a completed Change of Licensee (Operator) “Full” application.

If you currently operate a licensed assisted living facility in the State of Washington or if you are an affiliate of an entity currently licensed to operate an assisted living facility in Washington, fill out and submit a completed Change of Licensee (Operator) “Partial” application. (An “ affiliated entity” is an entity that is owned by a licensed entity, holds interest in a licensed entity, or is a subsidiary of a licensed entity).

If you currently operate a licensed assisted living facility in the State of Washington, intend to submit license applications to operate several additional facilities, and the applicant will be the same on all applications, fill out and submit a completed Change of Licensee (Operator) “Full” application for one of the facilities. Also, fill out and submit a completed Change of Licensee (Operator) “Mini” application for each additional facility. Submit all applications simultaneously.

If you do not know which Change of Licensee (Operator) application to use, call the Business Analysis and Application Unit at (360) 725-2420.

Before using a room for a purpose other than what was approved by Department of Health, Construction Review Services, you must: (1) notify Construction Review Services in writing at least thirty (30) days before the intended change in use; and (2) obtain written approval from Construction Review Services for the new use of the room. In the notice to Construction Review Services, you need to describe the current and proposed use of the room. All additional documentation requested by Construction Review Services must be provided.

Remodels require approval from the Department of Health, Construction Review Services (DOH-CRS). Contact DOH-CRS for review of all new assisted living facility construction. Write to: Department of Health, Construction Review Services, P.O. Box 47852, Olympia, WA 98504-7852. Phone: (360) 236-2944. Fax: (360) 236-2901. Email: fslcrs@doh.wa.gov. CRS approval must be obtained before the remodeled area may be used.

When DSHS is petitioning for the appointment of a guardian, objecting to a guardian’s fees or is asking the court to remove or modify a guardianship, the social worker/APS worker will usually be asked to describe the circumstances of the case and make recommendations to the court. This is called a declaration. In consultation with the Assistant Attorney General, you will be asked to address certain issues and state the facts and your first hand impressions truthfully in a narrative form. This is submitted to the AAG who prepares the legal document we will submit for your signature, under penalty of perjury. Case managers who have made a declaration are asked to attend the court hearing. They need to be available to answer any questions the Judge may have, but are rarely asked to add anything beyond their written submissions.

Yes.  There is a list of:

You cannot teach any CE curriculum without being a DSHS approved training program or a DSHS approved instructor of CE.

You do not need to submit an application as long as the transaction complies with WAC 388-78A-2770 (1)(d). You will need to send a letter to the Business Analysis and Application Unit explaining the transaction in detail.

If you do not know if you need to submit an application, call the Business Analysis and Application Unit at (360) 725-2420.

For various reasons, some guardians will have fees that are approved by the court but there was not sufficient participation at the time to pay them. These unpaid fees can be held over until additional participation is available. When participation becomes available, it is reduced an additional amount over and above the monthly guardianship fees and costs to cover that amount. Back fees are only paid if the Regional Administrator received proper notice at the time the court initially approved the fees.

Guardianship is a drastic measure, by which clients lost all or some of their decision-making ability. Not every adult needs a guardianship or even a limited guardianship, and guardianships can only be established when the person lacks capacity, as described above. If the only issue for a client is financial management, a representative payee for Social Security benefits may be all that is needed. If the issue is medical decision making, this could be addressed by ensuring that closely related family members are available to provide informed consent for treatment of medical emergencies. Other support needs may be satisfied by proper case management including providing eligible services or day programs.

When a petition is filed to establish a guardianship, the court appoints a guardian ad Litem (GAL). The GAL represents the client’s best interests (not the client him or herself) in the guardianship proceeding. The GAL also acts as a neutral investigator for the court. The GAL will arrange for a physician or psychologist to examine the client and, based in part on that examination, submit a report to the court on whether the client is legally incapacitated. The GAL also conducts an investigation to determine if the proposed guardian is fit to serve, The GAL writes up a report on his/her findings and recommends to the court what it should do. The final decision is always with the court itself. GAL’s also may have the power to make emergency medical decisions during the time they are appointed by the court. GAL’s may also petition the court for interim orders that may be necessary until the guardianship is established. Once the investigation is complete, the GAL is usually dismissed and no longer has decision making power for the person.

The options are the same as they are for most long term care worker courses.  Apply to DSHS to become a DSHS approved training program (or send in an update form if already approved) to offer CE or send staff to DSHS approved community instructors teaching CE. 

Individual Providers get their training from the SEIU Training Partnership. To sign up for training, call the Member Resource Center toll free at 1-866-371-3200 or visit www.myseiubenefits.org.

Guardians’ duties are outlined in the court order that appoints them. In general, this includes financial management, health care decision making, residential placement*, reporting to the court, and miscellaneous decision making in the best interest of the incapacitated person. Guardians should not be managing every aspect of a person’s life. They are not care providers. They should be facilitating and advocating with care providers for the person, but not performing the tasks themselves at an additional fee to DSHS.

*Note, however, that guardians may not consent to detain an incapacitated person in a residential treatment facility against their will.

A guardianship is a legal mechanism by which one individual or entity (a guardian) is appointed by a court to exercise certain decision making functions on behalf of, and in the place of, an individual that is legally “incapacitated.” When a guardianship is established, the incapacitated person’s legal right to make certain decisions with respect to his or her personal and/or financial affairs is removed and responsibility for making such decisions is placed in the court-appointed guardian.

A assisted living facility means any home or other institution, however named, which is advertised, announced, or maintained for the express or implied purpose of providing housing, basic services, and assuming general responsibility for the safety and well-being of the residents, and may also provide domiciliary care, consistent with Chapter 388-78A WAC to seven or more residents after July 1, 2000. A assisted living facility that is licensed for three to six residents prior to or on July 1, 2000, may maintain its assisted living facility license as long as it is continually licensed as an assisted living facility.

“Assisted living facility” does not include (1) facilities certified as group training homes pursuant to RCW 71A.22.040; (2) any home institution or section thereof which is otherwise licensed and regulated under the provisions of state law providing specifically for the licensing and regulation of such home, institution or section thereof; (3) any independent senior housing, independent living units in continuing care retirement communities, or other similar living situations including those subsidized by the Department of Housing and Urban Development.

An EIN number is the 9-digit number assigned to businesses by the Internal Revenue Service (IRS) for filing and reporting purposes. The applicant must have this number prior to applying for assisted living facility licensure and/or contract. A copy of the IRS CP-575 or SS-4 form showing the assigned EIN number will be accepted as verification an EIN was obtained.

The Unified Business Identifier (UBI) is a 9-digit number issued to individuals and companies doing business in the State of Washington. The applicant must have this number prior to applying for assisted living facility licensure and/or contract. A copy of the applicant’s Master License Service Registrations and Licenses (business license), the Certificate of Incorporation or Certificate of Formation issued by the Secretary of State, or any other official document issued by any State of Washington agency.

Domiciliary care means:

  1. Assistance with activities of daily living provided by the licensee either directly or indirectly; or
  2. Health support services, if provided directly or indirectly by the assisted living facility; or
  3. Intermittent nursing services, if provided directly or indirectly by the assisted living facility.

Licensed resident bed capacity means the resident occupancy level requested by the licensee and approved by the department. All residents receiving domiciliary care or the items or services listed under general responsibility for the safety and well-being of the resident as defined in WAC 388-78A-2020 count towards the licensed resident bed capacity. Adult day care clients do not count towards the licensed resident bed capacity. (The licensee is not required to license independent units / beds.)