Adult Day Services Center License (Rule 223)
Agency contact information:
Human Services (DHS), Minnesota Department of
P.O. Box 64242
St. Paul, MN 55164-0242
(651) 431-2000 | For TTY/TDD communication, use Minnesota Relay Service at 711 or (800) 627-3529
Division of Licensing
Contact Info: General questions email contact
The Minnesota Department of Human Services (DHS) offers programs for health care, child support, food support, general assistance, nursing home care, seniors, people who are deaf, people who have developmental disabilities, foster care, child protection and adult and children's mental health services.
Forms for adult day centers
Center director personnel requirements
Guidelines for Developing Polices & Procedures
Orientation Checklist for Participants
Orientation Checklist for Staff
Staff ratio requirements
Summary of staff information
Vulnerable Adults Maltreatment Reporting Policy Form
Forms for background studies
Initial Adam Walsh background study ID form
Consent for release of information from FBI national crime information databases to private child placing agency (required for background studies from private child placing agencies only)
Supplement to Application Form – DHS 3324 (CFC, AFC, FADS)
Consent for release of information from child abuse and neglect registry when background study subject resided outside Minnesota within last five years
MN Tax Identification Form
Initial Applicant Information Form
Worker's Compensation Insurance Form
Approval - Zoning
Approval - Fire Marshal
Approval - Building Code
Approval - Health Dept
More licensing forms are available on the MN Dept. of Human Services (DHS) website, at Licensing forms.
These standards describe:
1) developing programming to respond to identified needs of the individual;
2) ensuring rights of persons receiving services;
3) identifying staff qualifications, orientation and training requirements;
4) service expectations to ensure health and safety of persons receiving services; and
5) policy and procedure requirements of the program.
Licensing rules for adult day services
Initial license application fee - $550.
It is not prorated, is non refundable, and is in lieu of the annual license fee that expires on December 31.
No application will be processed until the application fee is paid.
Annual license fee - See Minn. Stat. § 245A.10.
Licensing surcharge to be assessed
The Minnesota Legislature passed legislation requiring a 10% surcharge of no less than $5 and no more than $150 on each business, commercial, professional or occupational license. The funding from this surcharge will go to MN.IT Services (formerly Office of Enterprise Technology (OET)), which is establishing an electronic licensing system for the state. The surcharge will be in place through June 30, 2015. See Minn. Stat. § 16E.22.
Period of Issuance:
Except for the initial license which is 12 months or less and expires on December 31, licenses are issued for one year on a calendar year basis.
Length of Determination Process:
Minn. Stat. § 245A.04, subd. 1 requires that the Commissioner shall act on the application with 90 working days after a complete application and any required reports have been received from other state agencies or departments, counties, municipalities, or other political subdivisions.
Other Pertinent Information:
Technical assistance may be obtained by contacting the DHS, Aging and Adult Services Division, at (651) 431-2600 (general information number).