1.An application for a license to provide CSU and any associated CSC and/or Temp Obs services/functions shall be submitted on forms made available by the Department in a format acceptable to the Department. No application shall be acted upon by the Department until the application is determined complete by the Department with all required attachments submitted.
2.The applicant shall submit the following documents to the Department no later than ninety (90) calendar days prior to the projected opening date of the CSU and any associated CSC and/or Temp Obs functions:
a. An accurate and complete application form;
b. A working budget showing projected revenue and expenses for the first year of operation, including revenue plan;
c. Documentation of working capital:
i. Funds or a line of credit sufficient to cover at least 90 days of operating expenses if the applicant is a corporation, unincorporated organization or association, a sole proprietor or a partnership;
ii. Appropriate revenue if the applicant is a state or local governmental agency, board or commission.
d. Documentation of authority to conduct business in the State of Georgia;
e. A separate twenty-four hour staffing plan for each service/function (CSU, CSC and/or Temp Obs) which includes nurses and physicians;
f. A floor plan with dimensions and with space and room function designations;
g. Number of proposed CSU beds; and proposed capacity in Temp Obs;
h. Photocopies of operating agreements with healthcare providers to provide care that is beyond the scope of the facility;
i. A program description signed by the medical director that includes, consistent with these rules and Department policy, admission and discharge criteria and procedures, including reasons for denial of admission, for both voluntary and involuntary individuals who do not meet admission criteria;
j. Proposed daily schedule of treatment and education options throughout twelve waking hours each day, to include treatment and educational opportunities responsive to the mental health, physical health and addictive disorder issues represented by individuals receiving services;
k. Fire Safety Documentation:
a. For new construction, additions, and renovation projects, written approval by the local Building authority as well as well as a fire safety report (e.g., Fire Safety Inspection Report or a Certificate of Occupancy) in the jurisdiction in which the CSU and any associated CSC and/or Temp Obs is based, must be submitted before a license is issued;
b. For buildings already constructed, a copy of a fire safety report indicating approval by the local fire authority for the jurisdiction in which the CSU and any associated CSC and/or Temp Obs is based, dated within the last twelve (12) months of the projected opening date must be submitted before a license is issued.
l. Documentation of agency accreditation as required by Departmental policy.
3. The Department shall conduct announced or unannounced on-site reviews of all facilities and services to determine compliance with the rules and regulations to operate a CSU and any associated CSC and/or Temp Obs functions, prior to a license being granted.
O.C.G.A. Sec. 37-1-29.
