TX HHS Form 3736. Application for State License to Operate a Type C Assisted Living Facility

The TX HHS Form 3736 is an application for state licensure to operate a Type C Assisted Living Facility. This form helps solve the problem of obtaining necessary permits and approvals to establish and maintain a residential care facility in Texas. The form is typically used by providers and adult foster care homes seeking to provide assisted living services to individuals.

The Form 3736 requires applicants to provide specific information, including facility details, provider credentials, and proof of insurance. The form also outlines conditions and responsibilities for operating an Assisted Living Facility, such as providing a safe and healthy environment for residents. Additionally, the form includes follow-up actions and procedures for ensuring compliance with state regulations.

To apply for licensure, applicants must complete the Form 3736 and submit it to the Texas Health and Human Services (HHS) department. The following key points should be noted:

• The form is specific to Type C Assisted Living Facilities.
• Applicants must provide required information and documentation.
• The form outlines conditions and responsibilities for operating an Assisted Living Facility.