Adult Family Care HomeThe Adult Family Care Home is a residential home designed to provide personal care services to individuals requiring assistance. The provider must live in the home and offers personal services for up to 5 residents. More detailed program information on adult family care homes can be found at the Department of Elder Affairs' Florida Affordable Assisted Living Website. |
Statute/Rule Authority
- Chapter 408, Part II, Florida Statutes (PDF) / (HTML)
- Chapter 429, Part II, Florida Statutes (PDF)/ (HTML)
- Chapter 58A-14, Florida Administrative Code (PDF) / (HTML)
Survey Guidelines
Adult Family Care Home Application Package
- Application Information and Instructions
- Application Packet Fees
- Fees Effective 8/1/2008
- AFCH Checklist
- AFCH License Application (AHCA Form 3180-1022)
- Health Care Licensing Application
- Health Care Licensing Addendum
- Voluntary Board Member Affidavit
- Affidavit of Compliance --Level 2 Background Screening for Covered Employees (AHCA 3100-0007)
- Affidavit of Compliance with Background Screening Requirement (AHCA 3100-0008)
- AFCH Statement of Income and Expense (AHCA Form 3180-1017)
- Dept. Of Health - Notice (Note: Applies to initial and renewal applications)
- Important Notice; AFCH Zoning Requirements
- Chapter 419, Florida Statutes
- Community Residential Home Affidavit of Compliance
- AFCH Local Zoning Form (AHCA Form 3180-1021)
- Homes licensed by the Agency for Health Care Administration--visit the AHCA website at http://www.floridahealthfinder.gov *
- Homes licensed by the Department of Children and Families--visit the DCF website at http://www.dcf.state.fl.us/districts/ to locate the Community Residential Home licensing staff in the appropriate district.
- Homes licensed by the Agency for Persons with Disabilities--visit the APD website at http://apd.myflorida.com/area/ to locate the APD staff in the appropriate district.
- Instructions *note: Adult Family Care Home (AFCH) Background Screening Affidavit of Compliance (Attachment)
- Background Screening Website--Contact the ALF unit for a valid FBI fingerprint card.
- Level 1 Criminal History Request Form (AHCA Form 3110-0002) *Note--Download from Background Screening Website
Community Residential Homes
* (Please do not use as the sole source of information for determining 1000 feet of distance between facilities)
Background Screening Package
Adult Family Care Home Renewal Application Package
- Renewal Application Information and Instructions
- Fees Effective 8/1/2008
- Checklist
- Application (AHCA Form 3180-1022)
- Health Care Licensing Application
- Health Care Licensing Addendum
- Dept. Of Health - Notice (Note: Applies to initial and renewal applications)
- Affidavit of Compliance --Level 2 Background Screening for Covered Employees (AHCA 3100-0007)
- Affidavit of Compliance with Background Screening Requirement (AHCA 3100-0008)
- Renewal Instructions *note: Adult Family Care Home (AFCH) Background Screening Affidavit of Compliance (Attachment)
- Background Screening Website--Contact the ALF unit for a valid FBI fingerprint card.
- Level 1 Criminal History Request Form (AHCA Form 3110-0002) *Note--Download from Background Screening Website
Background Screening Package (Renewal)
Resident Health Assessment
- Resident Health Assessment for Adult Family Care Homes (AHCA Form 3110-1023 AFCH-1110 01/08)
