Dear Interested Provider

Thank you for your interest in contracting as a vendor through Growing Abilities as an Adult/Child Developmental Home Provider (ADH/CDH). We offer equal opportunities to all vendor applicants on the basis of demonstrated ability, experience and training. We take pride in supplying the highest quality direct care providers in the State of Arizona. Again, thank you for your interest!

The first step in becoming an Adult/Child Developmental Home Provider (ADH/CDH) is to obtain an Applicant Questionnaire by contacting Carla Manzano via email Cmanzano@growingabilities.org  or phone at 480-452-7486 . The second step is to submit the completed ADH/ CDH Applicant Questionnaire to Carla Manzano via email.  After it has been received and reviewed to determine availability in your area, she will contact you to schedule a pre-screening interview. You must complete these 2 steps before you can sign up for any training.

We are contracted with the State of Arizona and most of our requirements are based on their mandates for being a certified provider. Below is a list of trainings that you must take in order to become certified in the State of Arizona through Growing Abilities. If you already have some of these items, please provide a copy of the certificate.

This is a list of trainings that you must take to become an ADH Provider. (Adult: 18-99)

*ADH Orientation to Growing Abilities (2 units)

*CPR & Bloodborne Pathogens (4 Units)

*First Aid and Assisting with Medication Administration (4 Units)

*ADH Training

 *Cultural Competency (2.5 units)

              *Incident reporting (2 units)

              *Article 9 (4 Units)

              *Habilitation (2 Units)

After you are licensed, you are required to complete 10 hours of Continuing Education each year in order to renew your license.

In consideration of your application for licensure, Growing Abilities, and the Office of Licensing, Certification, and Regulation (OLCR) will need you to provide various types of documentation to support your qualifications.

Proof of Income (one of these)
-Pay Stubs -W2-Tax Returns-1099 Form (self-employed)

Proof of Homeowner’s/Renter’s Insurance
-Declarations page

Criminal History Declaration (Growing Abilities will provide)
-Level One AZ Department of Public Safety Finger Print Clearance Card
-Criminal Self-Disclosure Declaration.

Transportation
-Valid Driver’s License (State, License Number, Expiration Date, Restrictions)
-Liability Insurance (Company Name, Coverage Expiration Date)
-Vehicle Registration (Car Year, Make, Model, Vehicle Identification Number, Expiration Date)

Reference (Growing Abilities will provide reference forms)
-3 Character References from people who are familiar with you and your family, but who are not related
-1 Employment Reference if you are currently working, or have worked, with children or adults with developmental disabilities.
-School References if you have school aged children (5-17)

Children’s Immunizations
-Immunization Records
-Statement of affiliation with a religion which is opposed to immunizations
-Statement of applicant opposition to such immunizations

Dog Rabies Vaccinations
-Rabies Vaccination Verification (Breed of dog and vaccination expiration date)
-Pet coverage must be listed on Insurance Declarations page specific to breed

Physician’s Statement
-Physician’s Statement (Growing Abilities will provide form)
-Health Self Disclosure (Growing Abilities will provide form)

Emergency Evacuation Plan

-Emergency Evacuation Plan

We are looking forward to meeting and getting to know you and your family. If you have any questions, please do not hesitate to contact Carla Manzano at (480) 452-7486 or Cmanzano@growingabilities.org

Thank you for taking an interest in our members and making them a part of your family.

Growing Abilities.