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Recovery Residence Certification
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Properties
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Property, Price, and Population
Complete this form for each property you operate using this model, including the property's pricing and population served.
Property Name
(Required)
If you refer to this property by a particular name, enter it here. Otherwise, enter "not applicable".
Program
(Required)
Please select the Program this Property belongs to.
Please make a selection
Property Address
(Required)
Street Address
Address Line 2
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Licensed treatment facility
(Required)
Is this property a state licensed treatment facility?
Yes
No
Monthly Resident Fee
(Required)
What's the monthly cost of living at this property? If you collect fees weekly, multiple by 4.33 to calculate the average monthly cost.
Refundable Deposit
(Required)
If residents are required to pay a refundable deposit at or before move-in, enter that amount here. If not, enter ("0") zero.
Nonrefundable Administration Fee
(Required)
If residents are required to pay a nonrefundable administrative fee at or before move-in, enter that amount here. If not, enter ("0") zero
Other Fees
(Required)
Describe any other fees that a resident may insure. Write “none”, if this does not apply.
Bed Capacity
(Required)
What is the total bed capacity? Include beds allocated to staff as well as empty beds. Capacity will be verified during onsite reviews. Falsifying information may result in certification denial or suspension and forfeiture of fees.
Property Start Date
(Required)
When did the property open as a recovery residence? (Date)
MM slash DD slash YYYY
Landlord Approval
(Required)
The owner of record (e.g. the landlord) has given the provider permission to use this property as a recovery residence.
Yes. In a written letter.
Yes. In a master lease.
Yes. Other
No. The property is owned by the recovery residence owner/operator
No. Seeking variance.
Number of Dwellings / Buildings
(Required)
How many dwellings or buildings are on this property?
Dwelling / Feature Types
(Required)
What type of dwellings or features are on this property?Choose all that apply.
Single dwelling (single house/cottage or bungalow)
Multi dwelling (Fourplex/apartments/row houses)
Commercial building
Pool/basketball court/or other recreational area
Outdoor living space
Other
Zoning
(Required)
This property is sited on what type of zoning? Choose the best answer.
Residential zoning: single family
Residential zoning: multi family
Residential zoning: other
Commercial / industrial zoning (e.g. office building, hotels, warehouse, nursing home)
Agriculture / rural zoning (rural areas)
Historic zoning (historical preservation)
Other
Hazard Free
(Required)
Do you attest that electrical, mechanical, and structural components of the property are functional and fee of fire and safety hazards?
Yes. I attest to that fact.
No. Seeking variance.
Code Compliance
(Required)
Do you attest that the residence meets local health and safety codes appropriate to the type of occupancy?
Yes. I attest to that fact.
No, but I can documentation from an inspector who has.
No. Seeking variance.
Property Inspection Documents
(Required)
Upload property inspection documentation. [Note: We recommend you upload using one of the following file formats: jpg, gif, png, pdf]
Accepted file types: jpg, gif, png, pdf, docx, doc, Max. file size: 16 MB.
Gender and Age
(Required)
What population lives at this property? Gender and age requirements
Adult women
Adult men
Adult/no gender restriction
Adolescent girls
Adolescent boys
Adolescent no gender restriction
Mothers with children
Fathers with children
Parents with children
Other
Population Specialization
(Required)
Does this property further specialize in a particular population?
Do not categorically exclude/but do not further specialize
Medication Assisted Treatment (MAT)
Veterans
Co-occurring
Re-entry
LGBT+
Physically disabled/impaired
Eating disorders
Gambling disorder
Other
Property Point of Contact (Name)
(Required)
Used to coordinate the onsite review
First
Last
Property Point of Contact (Email)
(Required)
Property Point of Contact (Phone)
(Required)
Certification Outline
Recovery Residence Certification
Orientation
Certification Process
User Agreement
Frequently Asked Questions
Levels of Support
NARR Standards
Provider Information
Administrator Information
Eligibility Self Screening
Policies, Documents and Attestations
Policies and Procedures
Liability Insurance
Landlord Agreement(s)
Compliance
Marketing
Conflicts of Interest
Resident Agreements
Staff and Leaders
Programs and Properties
Programs (Service Models)
Properties
