21 NCAC 37D .0402         APPLICATION TO BECOME ADMINISTRATOR-IN-TRAINING (AIT)

(a)  The applicant shall submit to the Board an application containing:

(1)           name;

(2)           education;

(3)           employment history;

(4)           questions pertaining to moral character;

(5)           criminal history; and

(6)           an affidavit stating that the applicant if granted a license, shall obey the laws of the state and the rules of the Board, and shall maintain the honor and dignity of the profession.

(b)  The applicant shall submit a resume.

(c)  The applicant shall submit three reference forms (one employer and two character) as set forth in Rule .0203 of this Subchapter:

(1)           the Employer Reference Form shall include the address of employment and duties assigned; and

(2)           the Character Reference Form shall include how this individual knows the applicant and whether the applicant is capable to supervise the care of residents of a skilled facility. No character reference shall be from a relative of the applicant.

(d)  The applicant shall submit an official transcript issued by the institution indicating the courses completed and hours earned, specifying whether semester or quarter hours. The applicant shall supply documentation of his or her supervisory experience in a nursing home if the applicant is utilizing the experience substitute for the education requirement as allowed by G.S. 90-278(1)b.

(e)  The applicant and the preceptor shall appear before the Board for a personal interview.

(f)  The preceptor shall submit to the Board three weeks prior to the personal interview:

(1)           a Facility Survey Form stating the facility license number, address, and the number of beds;

(2)           a letter accepting the individual as an AIT;

(3)           a Preceptor Disclosure Form stating number of years the individual has served as an administrator and number of AITs precepted;

(4)           a curriculum outline for the AIT program that provides the AIT with job experience in each department. A curriculum outline shall include each department in the facility and the information that will be covered, including the recommended number of weeks in the program as outlined on the AIT Curriculum Request and Rationale Form;

(5)           an AIT Curriculum Request and Rationale Form shall be based on education and experience of the AIT applicant. The preceptor shall be responsible for providing a rationale for all subject areas with the recommended number of weeks for the AIT; and

(6)           the directions to the facility.

(g)  The owner or governing board of the facility shall submit to the Board three weeks prior to the personal interview a letter of approval for the AIT applicant to train in the facility.

(h)  A non-refundable processing fee of three hundred dollars ($300.00) shall be submitted with the application.

(i)  An AIT applicant shall maintain at all times a current residential mailing address with the Board office.

(j)  The applicant may obtain an application and forms from the Board's website or from the Board office.

History Note:        Authority G.S. 90‑278; 90‑280; 90‑285; 90-288.01;

Eff. February 1, 1976;

Amended Eff. August 1, 1977; April 8, 1977;

Readopted Eff. December 15, 1977;

Amended Eff. February 1, 1980;

Readopted Eff. October 1, 1981;

Amended Eff. August 1, 1995; August 2, 1993; February 1, 1991; May 1, 1989;

Transferred and Recodified from 21 NCAC 37A .0502 Eff. April 1, 1996;

Amended Eff. July 1, 2014; July 1, 2004; April 1, 1996;

Readopted Eff. October 1, 2015;

Amended Eff. January 1, 2021.