OAR 411-348-0045
In-Residence Caregiver Applicant Study


A program provider submitting an application for licensure of a Host Home must complete and submit an In-Residence Caregiver Applicant Study. The In-Residence Caregiver Applicant Study must contain documentation of all of the following:


The names and ages of all occupants of the home, including identification of which adults shall be responsible for providing care and support to children residing in the home and which, if any, adults residing in the home are dependent upon care.


Reports of all criminal charges, arrests, or convictions, including the date of the offense and the resolution of those charges, for all occupants of the home. If minor children of an in-residence caregiver are residing in the home, the In-Residence Caregiver Applicant Study must also list reports of all criminal or juvenile delinquency charges, arrests, or convictions, including the date of the offense and the resolution of those charges.


Founded reports of child abuse or substantiated abuse, including dates, locations, and resolutions of those reports, for all occupants of the home.


Names and addresses of any agencies in the Unites States where any occupant of the home has been licensed or certified to provide care to children or adults and the status of such license or certification, including license or certification for foster or residential care or nursing.


Any professional licenses or certifications currently or previously held by the in-residence caregiver or other adult occupants of the home, and the status of each license or certificate.


Copy of the in-residence caregiver’s current driver’s license and proof of insurance coverage on all vehicles used by the in-residence caregiver to provide transportation to children.


Disclosure of any current or past Medicaid Provider Enrollments or Medicaid Provider Identifications held by occupants of the home, including a report of the status of each enrollment. Any reported termination of Medicaid enrollment or identification must include a description of the reason for the termination.


Completed character reference checks for the in-residence caregiver. There must be four character reference check sources for each in-residence caregiver who have known the in-residence caregiver for two years or more and can attest to the character of the in-residence caregiver and the in-residence caregiver’s ability to care for children. Three of the reference check sources may not be related to the in-residence caregiver.


A physician’s statement for the in-residence caregiver that the in-residence caregiver is physically and mentally capable of providing care, to the extent that there are no known issues that prevent or interfere with the in-residence caregiver’s ability to provide care to a child.


A disclosure of all past residences in the last five years for the in-residence caregiver. The disclosure must include the address, city, state, and zip code.


A statement from the program provider recommending the in-residence caregiver based on the belief the in-residence caregiver has the necessary skills, knowledge of child development, temperament, and resources to provide a stable and nurturing family home environment for a child placed in the Host Home. The program provider must assess the in-residence caregiver’s ability to demonstrate all of the following attributes:


Responsible, stable, emotionally mature adult who exercises sound judgment.


Interest, motivation, and ability to nurture, support, and meet the mental, physical, developmental, and emotional needs of a child placed in the Host Home.


Willing to receive training and have the ability to learn and use effective child-rearing practices to enable a child placed in the Host Home to grow, develop, and build positive personal relationships and self-esteem.


Demonstrates the knowledge and understanding of positive supports and ways of helping a child build positive personal relationships, self-control, and self-esteem.


Respects a child’s relationship with their parents and siblings and is willing to work in partnership with family members, agencies, and schools involved with a child placed in the Host Home to attain the goals as listed in the child’s IEP, ISP, and other care plans.


Respects a child’s privacy in accordance with the child’s age and care needs.


Has supportive ties with others who might support, comfort, and provide advice, such as family, friends, neighborhood contacts, churches, or community groups.


Demonstrates a lifestyle and personal habits free from abuse or misuse of alcohol or drugs.


Is able to realistically evaluate which children the in-residence caregiver may accept, work with, and integrate into their family home.


Adults (other than the in-residence caregiver and program provider) having regular contact with a child placed in a Host Home, including volunteers, family members, acquaintances of the in-residence caregiver, and any subject individual as defined in OAR 407-007-0210 (Definitions), must also be identified and documentation of a completed background check must be submitted to the Department with the In-Residence Caregiver Applicant Study. Regular contact applies to visitors who have any role in supervising or providing direct care to children in the home, regardless of frequency of visit to the home.


The Department may require documentation of an approved background check on members of an in-residence caregiver’s household who are under the age of 18 if there is reason to believe that a minor household member may pose a risk to children placed in the home. Background checks required by the Department for minor household members must be included in the In-Residence Caregiver Applicant Study.


The Department may not proceed with the licensing of a Host Home if the In-Residence Caregiver Applicant Study is not complete.


Falsification or omission of any of the information of the In-Residence Caregiver Applicant Study may be grounds for denial or revocation of a Host Home license.

Source: Rule 411-348-0045 — In-Residence Caregiver Applicant Study, https://secure.­sos.­state.­or.­us/oard/view.­action?ruleNumber=411-348-0045.

Statement of Purpose
Definitions and Acronyms
Program Management, Endorsement, Certification, and Enrollment
Issuance of License
Application for Initial License
In-Residence Caregiver Applicant Study
License Expiration, Termination of Operations, and License Return
License Conditions
License Renewal
Change of Ownership, Legal Entity, Legal Status, Management Corporation, and In-Residence Caregiver
Medical Services
Food and Nutrition
Physical Environment
General Safety
Staffing Requirements
Individual Summary Sheets
Emergency Information
Transition Planning and Supporting Families
Required Furnishings
Emergency Plan and Safety Review
Assessment of Fire Evacuation Assistance and Fire Safety Evacuation Plan
Fire Drill Requirements and Fire Safety
Fire Safety Evacuation Plans
Fire Safety Requirements
Rights, Complaints, Notification of Planned Action, and Hearings
Behavior Supports and Physical Restraints
Psychotropic Medications and Medication for Behavior
Personal Property
Financial Records and Managing Money
Entry, Exit, Transfer, and Closure
Alternative Care, Childcare, Camp, and Alternate Caregivers
Individual Support Plan
Civil Penalties
License Denial, Suspension, Revocation, and Refusal to Renew
Criminal Penalties
Provider Eligibility for Medicaid Service Payment
Last Updated

Jun. 8, 2021

Rule 411-348-0045’s source at or​.us