DCF 54.02(2)(d)4. 4. Consult with the department prior to the establishment of a new agency or the changing of a basic program of care of an existing agency or the extension of service into additional program or geographic areas.

DCF 54.02(2)(d)5. 5. Notify the department when there is a change in the executive of the agency and/or the chief officer of the board.

DCF 54.02(2)(d)6. 6. Notify the department of any major changes pending or occurring in the corporate structure, organization or administration of the agency.

DCF 54.02(3) (3) Application.

DCF 54.02(3)(a) (a) The board shall submit to the department an application to operate an agency in a form prescribed by the department for a license. The application shall be signed by the chief officer of the board and the agency executive. It shall not operate the agency until it receives such a license.

DCF 54.02 Note Note: An application form may be obtained from the department’s website at http://dcf.wisconsin.gov or by writing or telephoning any field office listed in Appendix A.

DCF 54.02(3)(b) (b) If the board is applying for a license for the first time the application shall be submitted at least 60 days prior to the date on which it proposes to begin operation.

DCF 54.02(3)(c) (c) The following material shall accompany the first application for a license:

DCF 54.02(3)(c)1. 1. A copy of the articles of incorporation and if existent, a copy of the constitution and by-laws.

DCF 54.02(3)(c)2. 2. Evidence of the availability of funds to carry the agency through the first year of operation.

DCF 54.02(3)(c)3. 3. A statement of purpose which includes a description of the geographic area to be served, the types of children to be accepted for care, the services to be provided and the program objectives.

DCF 54.02(3)(c)4. 4. A general description of each type of position proposed for the agency.

DCF 54.02(3)(c)5. 5. A proposed organization chart insuring that there will be staff in number and qualifications for the scope of the agency services.

DCF 54.02(3)(c)6. 6. A list of board members including the addresses of the officers of the board.

DCF 54.02(3)(c)7. 7. A proposed per client administrative rate that the child-placing agency will charge for services for foster homes with a Level 3 or 4 certification in the current year and a proposed budget with the same cost categories as the department’s cost and service report under s. DCF 54.09 (1) (a).

DCF 54.02(3)(d) (d) Subsequent applications shall be submitted to the department:

DCF 54.02(3)(d)1. 1. At least 30 days prior to the continuation date of the current license.

DCF 54.02(3)(d)2. 2. When an additional office is to be opened.

DCF 54.02(3)(d)3. 3. When a new program subject to licensing is to be initiated.

DCF 54.02(3)(d)4. 4. When the geographic area served is to be extended.

DCF 54.02(3)(d)5. 5. When the address of the agency is to be changed.

DCF 54.02(3)(d)6. 6. When the name of the agency is to be changed.

DCF 54.02(3)(e) (e) Subsequent applications shall be sent with the following materials:

DCF 54.02(3)(e)1. 1. Copies of the annual reports published since the last license was issued.

DCF 54.02(3)(e)2. 2. The budget for the current fiscal year and the most recent financial audit.

DCF 54.02(3)(e)3. 3. A list of the current members of the board of directors and its committees.

DCF 54.02(3)(e)4. 4. The number, names, qualifications and classifications of current staff.

DCF 54.02(3)(e)5. 5. A copy of the current staff organization chart.

DCF 54.02(3)(e)6. 6. A description of any program review and evaluation and changes in program content and purpose which have occurred since the last license was issued.