New Administrators Application for Conditional Certificate

Due to  COVID 19, the ACS section is not currently scheduling exams
The state will issue you a conditional ARF Administrator Certificate.
You will be required to take the exam at a future date.  Click on the links below for more information.

Conditional Administrator Certificate
 Provider Information Notice ( page 9).

After Completing the ARF ICTRP Course Submit To Licensing:

Administrator Certification Application  
Include a note that you are applying for a  Conditional Administrator Certificate.
Include the certificate issued to you on completion of the Administrator Certification Course.
Criminal Record Statement
Request for Livescan

Livescan for new administrators:
ORI: A0448
OCA Dummy #345588888
Facility Number:  LIC number of the facility you are employed with. If you are not employed by an existing facility write in NA.
Name of Employer:   Your employer.  If you are not employed by a facility write in NA.

Fngerprint CLearance
If you already have Criminal Record Clearance through  your work in a Community Care Facility you do not need to get fingerprinted again. You will need to complete the criminal record statement above and send in a copy of your current clearance. Licensing will not accept your clearance through other agencies such as the Board of Consumer Affairs and Law Enforcement.




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