22VAC40-90-30. Sworn statement or affirmation.

Part II. The Sworn Statement or Affirmation

A. The applicant for licensure shall complete a sworn statement or affirmation upon application for licensure as an assisted living facility.

B. The sworn statement or affirmation shall be completed for all applicants for employment. A model form is available from the department upon request and on the department's website.

C. Any person making a materially false statement on the sworn statement or affirmation shall be guilty of a Class 1 misdemeanor.

D. Further dissemination of the sworn statement or affirmation information is prohibited other than to the Commissioner of the Department of Social Service's representative or a federal or state authority or court as may be required to comply with an express requirement of law for such further dissemination.

Statutory Authority

§§ 63.2-1702, 63.2-1720, and 63.2-1721 of the Code of Virginia.

Historical Notes

Derived from VR615-37-01 § 2.1, eff. July 1, 1989; amended, Virginia Register Volume 8, Issue 17, eff. July 1, 1993; Volume 21, Issue 18, eff. July 1, 2005; Volume 22, Issue 22, eff. September 1, 2006; Volume 41, Issue 22, eff. August 15, 2025.

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