Survey and Certification Background Checks Notification
17 May 2017
Disabilities, Aging and Independent Living
Division of Licensing and Protection
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Form
Resident Assessment Form
15 February 2017
Survey & Certification Reporting Form
15 February 2017
Tax Compliance Form
15 February 2017
Therapeutic Community Residence New Facility Licensure Packet
15 February 2017
Residential Care Home New Facility Licensure Packet
15 February 2017
Assisted Living Residence - New Facility Licensure Packet
15 February 2017
CLIA Laboratory Certification
15 February 2017
Residential Care Transfer-Discharge Letter
15 February 2017
Residential Care Home Floating License Model Pilot Proposal
14 February 2017
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Contact Us
Division of Licensing and Protection
HC 2 South, 280 State Drive
Waterbury, VT 05671-2060
For Telecommunications Relay Service: Dial 711
Clayton Clark
Division Director
(802) 241-0345
Joe Nusbaum
Assistant Director Adult Protective Services
(802) 241-0512
Suzanne Leavitt
Assistant Director Survey and Certification
(802) 241-0480
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Limited English Proficiency (LEP)
This is a Division of the
Department of Disabilities, Aging and Independent Living
under the Agency of Human Services