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Get Cbrf Form Online 2016

LICENSURE CHECKLIST Name - CBRF Name Reviewer Address - Facility (Street Address) A. Date Form Completed City County Zip Code A completed application includes the following items. 1. Completed CBRF Initial License Application (DHS form F-60287) 2. Background check completed by Office of Caregiver Quality on the licensee and all non-residents age 10 and older 3. Floor plan (no larger than 11 x 17 ) DHS 83.05(2)(b) 4. A biennial licensing fee of $389, plus $50.25 per resident bas.

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