Personal Care Home Licensing
The following forms below are offered in PDF format; all forms are fill-in enabled. If a Word version of any form is needed, please contact the department's Operator Support Hotline at 1-866-503-3926 or email the ARL Headquarters Office.
Sample Model Forms
Regulations & Interpretations
Interpretations — Questions/Answers
All individuals that complete the 100-hour standardized department-approved administrator training course after Jan. 31, 2009 must successfully complete the test with a passing score in accordance with 55 Pa.Code § 2600.64(a)(3) (relating to administrator training and orientation). The test must be successfully completed prior to an individual being hired as an administrator. Additionally, an individual who completed the 100-hour course prior to January 1, 2009, and who was hired or promoted to work as an administrator on or after April 1, 2012, must take and pass the competency test.
In accordance with 55 Pa.Code § 2600.64(g), a licensed nursing home administrator hired as a personal care home administrator after Jan. 31, 2009, must complete and pass the department-approved personal care home administrator competency-based training test. Contact a department-approved 100-hour training institution for available dates/times and fees to complete the test.
Direct Care Staff Person Training Course and Competency Test
All direct care staff persons hired after Oct. 31, 2007, who will provide unsupervised Activities of Daily Living (ADL) services must successfully complete the course and pass the competency test in accordance with 55 Pa.Code § 2600.65(d)(2) and (d)(3) (relating to direct care staff person training and orientation). The course/test must be completed prior to direct care staff persons providing unsupervised ADL services.
Please be aware that the Department does not maintain a database of individuals who complete the course/test. Therefore, please ensure that you print out your certificate of completion before logging off, as only proof provided regarding completion of the course/test.
Please also note that each individual taking the course/test must successfully log out of the course/test before another individual logs in to take the course/test. A certificate of completion will not print properly and/or be accurate if this is not done.
Training for Trainers of Personal Care Home Administrators:
To become a Department of Human Services-approved training institution: