(A) The application for a license to conduct and operate a home regulated by this chapter shall be made in conformity with the general requirements of the Code of Crestwood relating to applications for licenses. The application shall be under oath and shall contain:
(1) The name and address of the applicant, if an individual; if a firm, partnership or association, the name and address of every member thereof; and if a corporation, the names and addresses of its officers;
(2) The location of the proposed home for which a license is sought;
(3) The name of the person under whose management or supervision the home will be conducted and proof that such person is licensed as a nursing home administrator by the Illinois Department of Registration and Education;
(4) The number and type of residents for which maintenance, personal care or nursing will be provided; and
(5) Such information relating to the number, experience and training of the employees of the home, and of the moral character of the applicant and employees as the Mayor or his or her designated village employee or inspector may deem necessary.
(B) Each application shall be accompanied by a written statement of applicant’s financial good standing.
(C) As a condition of the issuance or renewal of a license, the applicant shall file with the village a statement of ownership which the applicant or licensee shall update within 30 days of any change in ownership or management. The statement of ownership shall include:
(1) The name, address, telephone number, occupation or business activity, business address and business telephone number regarding every person who has entered into a contract to manage or operate or who owns or controls, directly or indirectly, any of the shares of stock of, or any other financial interest in, the facility which is the subject of the application or license, and the value and percentage of such interest; and
(2) The address of any facility, wherever located, in which any financial interest is owned or controlled, directly or indirectly, by the applicant, if the facility is required to be licensed as if it were located in the state.
(3) If the licensee has delegated authority to any management company, in whole or part for operation of its facilities, such manager shall also apply for a village license prior to the commencement of operations and adhere to all standards of this chapter. Further, the operator of the facility shall provide the village 30 days’ prior notice of its intent to hire or contract with such management company.
(4) The statement of ownership shall be forwarded to the Illinois Department of Public Health after the issuance of the village license.
(Ord. 2247, passed 9-3-2015)