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
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.
Plans of Correction
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 ensure that you print out your certificate of completion before logging off, as it is the only proof provided regarding completion of the course/test.
Please also note that each individual taking the course/test must register individually with thier own email address in order to access the course. Please note that registering for the course and accessing the course is a two-step process that takes place on two different platforms.
Training for Trainers of Personal Care Home Administrators:
To become a Department of Human Services-approved training institution: