Administrative Code

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Virginia Administrative Code
Title 18. Professional and Occupational Licensing
Agency 95. Board of Long-Term Care Administrators
Chapter 30. Regulations Governing the Practice of Assisted Living Facility Administrators
7/10/2020

Forms (18VAC95-30)

Assisted Living Facility Administrators Education and Experience Matrix (rev. 3/2019)

Assisted Living Facility Administrator Application for Licensure - form available online only at https://www.dhp.virginia.gov/nha/nha_forms.htm#alfa

Assisted Living Facility Administrator Administrator-in-Training Application - form available online only at https://www.dhp.virginia.gov/nha/nha_forms.htm#alfa

Monthly Report of Assisted Living Facility Administrator-in-Training (rev. 3/2019)

Assisted Living Facility Administrator-in-Training Documentation of Completion Form (rev. 3/2019)

Assisted Living Facility Administrator-in-Training Notice of Change of Status or Discontinuance (rev. 3/2019)

Assisted Living Facility Administrator Preceptor Application - form only available online at https://www.dhp.virginia.gov/nha/nha_forms.htm#alfa

Proposed AIT Training Plan Domains of Practice (rev. 3/2019)

Checklist and Instructions for Assisted Living Facility Administrator Reinstatement Application (rev. 3/2019)

Checklist and Instructions for Assisted Living Facility Administrator Preceptor Reinstatement Application (rev. 3/2019)

Checklist and Instructions for Acting Assisted Living Facility Administrator-in-Training (rev. 3/2019)

Continuing Competency Activity and Assessment Form for Assisted Living Facility Administrators (rev. 9/2010)

Continuing Education (CE) Credit Form for Volunteer Practice (eff. 2/2018)

Name/Address Change Form (rev. 3/2019)

Request for Verification of Virginia NHA or ALFA License (eff. 3/2019)

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As a service to the public, the Virginia Administrative Code is provided online by the Virginia General Assembly. We are unable to answer legal questions or respond to requests for legal advice, including application of law to specific fact. To understand and protect your legal rights, you should consult an attorney.