TX HHS Form 2819. CCR Residential Child Care Regulation Governing Body and Administrator

Form 2819 is used by child-care operations in Texas to officially designate two key roles: a designee who may speak and act on behalf of the governing body, and an administrator responsible for the day-to-day management of a residential child-care operation. The form may look simple at first glance, but it carries significant legal consequences. Incorrect or incomplete designations often lead to delays in licensing actions, missed compliance notices, or invalid authorization of waivers and variances.

Purpose of Form 2819

Texas Child Care Regulation (CCR) requires every licensed residential child-care operation to have clear, documented lines of authority. Form 2819 fulfills that requirement by identifying who can legally represent the governing body and who is responsible for overseeing the operation itself.

You may complete only Section 1, only Section 2, or both—depending on the change your organization needs to report.

Explanation of Key Sections

Section 1 – Designee

This section identifies the individual authorized to act for the governing body. In practice, this is often an assistant director, senior manager, or another trusted representative. The designee receives compliance documents, routine correspondence, and may sign certain official requests on behalf of the facility.

• Operation Information: The form first asks for the operation’s name, number, address, and phone. These must match the information on file with CCR. A frequent mistake is listing a mailing address instead of the physical location.
• Governing Body Details: CCR requires the legal entity that owns or controls the operation to be properly documented. The form captures its name, address, and contact phone.
• CEO or Head of Governing Body: This identifies the person ultimately accountable for compliance. Their information must be precise, since CCR uses it for formal notices.
• Designee’s Information: This includes the designee’s name, address, and phone. The form asks whether these are residential or personal numbers. These questions help CCR determine where official documents may legally be sent.
• Routing of Correspondence: You must indicate whether routine communications should go to the CEO or remain directed to the designee. Many operations mistakenly check “CEO” even though they intend the designee to handle day-to-day communications.

Section 2 – Administrator

This section appoints the individual responsible for managing the childcare operation. The administrator must meet specific qualifications under Texas Administrative Code, including background checks and training requirements.

If the administrator leaves, is replaced, or has a name change, Form 2819 must be updated promptly. CCR treats administrator designation as a major compliance item because it directly affects children’s safety.

Section 3 – Certification and Signature

This is the legal attestation section. By signing, the governing body acknowledges several important obligations:

• All compliance notices will be sent to the designee.
• The governing body remains fully responsible for meeting CCR rules—even if a designee or administrator acts incorrectly.
• Waivers or variances must be signed by the governing body or its designee.
• Any change in designee or administrator must be reported immediately.
• HHSC will notify both the governing body and all controlling persons about enforcement actions.

A common mistake here is allowing someone to sign who does not have legal authority. Only the governing body or its official representative may certify the form.

Practical Guidance for Completing the Form

• Use full legal names—no nicknames or abbreviations.
• Verify that addresses match those used for licensing records.
• Do not list personal cell numbers as “business numbers” unless the individual agrees to receive official notices on that phone.
• Double-check spelling, especially for the administrator’s name, since it must match background-check records.
• If both roles are changing, complete both Sections 1 and 2 to avoid CCR returning the form for correction.

Examples of Real-World Use

• Example 1: A residential treatment center hires a new program director who will manage daily operations. The governing body must submit Form 2819 to designate them as the administrator.
• Example 2: The CEO is frequently unavailable, so the organization appoints a senior manager as the designee to receive compliance notices and communicate with CCR.
• Example 3: An operation expands to a new location and restructures its leadership. Form 2819 is used to update both the designee and the administrator.
• Example 4: The previous administrator resigns unexpectedly. To remain compliant, the governing body files Form 2819 immediately to designate the interim administrator.

Documents Commonly Attached

• Proof of administrator qualifications (training, certifications)
• Updated organizational chart
• Employment or appointment letter for the designee
• Background check confirmation (if required separately)

FAQ

• Who is allowed to sign Form 2819? The governing body or an authorized representative with legal authority.
• Do I need to submit the form for temporary role changes? Yes. CCR requires notification anytime there is a change in the designee or administrator, even if temporary.
• How quickly must changes be reported? As soon as possible. Delayed reporting is a common compliance violation.
• Does the designee replace the governing body? No. The governing body remains legally responsible for compliance.
• Where do I submit the completed form? Submit it to your assigned CCR representative or regional office.
• Can one person serve as both designee and administrator? Yes, if the governing body authorizes it and the individual meets administrator qualifications.
• Will CCR notify the administrator directly? Compliance documents go to the designee unless otherwise requested.

Micro-FAQ (Short Answers for Quick Reference)

• Purpose? To designate a designee and/or administrator for a child-care operation.
• Who files? The governing body of a licensed residential child-care operation.
• Deadline? Immediately upon any change in roles.
• Attachments? Administrator qualification documents, organizational chart, supporting letters.
• Submitted to? Your CCR representative or regional office.
• Legal effect? The designee becomes the primary recipient of compliance notices.
• Can admin and designee be the same person? Yes, if qualified.
• Does CCR verify addresses? Yes, inaccurate addresses cause delays.
• Is a signature required? Yes, certification must be signed by the governing body.
• What if information changes? File a new Form 2819 immediately.

Related Forms

• CCR Background Check Request
• Administrator Qualifications Checklist
• Governing Body Statement Form

Form Details

• Form Name: Residential Child Care Regulation Governing Body and Administrator
• Form Number: 2819
• Agency: Texas Health and Human Services – Child Care Regulation (CCR)
• Scope: Residential Child Care Operations
• Revision Date: April 2025