Regulation 3(2)(a) and (5)
1. Where the applicant is an individual –
(a)if he intends to carry on the establishment or agency in partnership with others, the information specified in the following sub-paragraphs of this paragraph in relation to each partner of the firm;
(b)the responsible person’s full name, date of birth, address and telephone number;
(c)details of his professional or technical qualifications, and experience of carrying on an establishment or agency, so far as such qualifications and experience are relevant to providing services for persons to whom services are to be provided at the establishment or by the agency;
(d)details of his employment history, including the name and address of his present employer and of any previous employers;
(e)details of any business he carries on or has carried on;
(f)the name and addresses of two referees –
(i)who are not relatives of the responsible person;
(ii)each of whom is able to provide a reference as to the responsible person’s competence to carry on an establishment or agency of the same description as the establishment or agency; and
(iii)one of whom has employed the responsible person for a period of at least 3 months,
but the requirement for the name and address of a referee who has employed the responsible person for a period of at least 3 months shall not apply where it is impracticable to obtain a reference from a person who fulfils that requirement.
2. Where the applicant is a partnership –
(a)the name and address of the partnership;
(b)in relation to each member of the partnership, the information specified in paragraph 1(b) to (f).
3. Where the applicant is an organisation –
(a)the name of the organisation and the address of the registered office or principal office of the organisation;
(b)the full name, date of birth, address and telephone number of the responsible individual;
(c)details of the professional or technical qualifications of the responsible individual and his experience of carrying on an establishment or agency of the same description as the establishment or agency, so far as such qualifications and experience are relevant to providing services for persons for whom services are to be provided at the establishment or by the agency;
(d)if the organisation is a subsidiary of a holding company, the name and address of the registered or principal office of the holding company and of any other subsidiary of that holding company.
4. In every case, other than where the applicant is an officer of a Health and Social Services Board or HSS trust –
(a)a reference from a bank expressing an opinion as to the applicant’s financial standing;
(b)a statement as to whether the responsible person has been adjudged bankrupt, or sequestration of his estate has been ordered, or he has made a composition or arrangement with, or granted a trust deed for, his creditors;
(c)a statement as to the applicant’s ability to ensure the financial viability of the establishment or agency for the purpose of achieving the aims and objectives of the establishment or agency set out in its statement of purpose;
(d)a business plan in respect of the establishment or agency;
(e)details as to cash-flow in respect of the establishment or agency.
5. The name, address, telephone number, facsimile number, and electronic mail address (if any) of the establishment or agency.
6. The description of establishment or agency specified in Article 8(1) or (2) or (3) of the Order in respect of which the applicant seeks to be registered.
7. The statement of purpose of the establishment or agency.
8. A statement as to the accommodation, facilities and services which are to be provided by the establishment or agency including the extent and, where appropriate, location of such accommodation, facilities and services.
9. The date on which the establishment or agency was established or is proposed to be established.
10. Details of the scale of charges payable by the service users.
11. In respect of the premises to be used by an establishment –
(a)a description of the premises, including a statement as to whether the premises are purpose-built or have been converted for use as an establishment;
(b)a description of the area in which the premises are located.
12. In respect of the premises to be used by an establishment or for the purposes of an agency, a statement as to whether at the date the application is made the premises are capable of being used for the purpose of –
(a)achieving the aims and objectives set out in the statement of purpose of the establishment or agency; and
(b)providing facilities and services in accordance with the statement referred to in paragraph 8,
without the need for planning permission, building works, or conversion of the premises and, if the premises are not capable of such use at the date the application is made, details of the planning permission, building works or conversion needed.
13. A statement as to the security arrangements, including arrangements for the purposes of –
(a)safeguarding access to information held by the establishment or agency; and
(b)restricting access from adjacent premises or, when the premises form part of a building, from other parts of the building.
14. The name and address of any other establishment or agency of a description specified in Article 8(1) or (2) of the Order in which the applicant has or has had a business or financial interest, or at which he is or has been employed, and details of such interest or employment.
15. Whether any other business is or will be carried on in the same premises as those of the establishment or agency and, if so, details of such business.
16. In respect of any person, other than the applicant, who works at, or is intended to work at the establishment or for the agency –
(a)the person’s name, sex and date of birth;
(b)the person’s duties and responsibilities in relation to his work.
17. In respect of any person, other than the applicant, who works at, or is intended to work at the establishment or for the purposes of the agency –
(a)whether the person is, or is intended to be, resident in the premises used as the establishment or for the purposes of the agency;
(b)if he is a relative of any person who has made an application in respect of the establishment or agency, his relationship to such person;
(c)whether the person works or is intended to work, on a full-time basis or on a part-time basis and, if on a part-time basis, the number of hours per week for which it is intended that the person will work;
(d)the date on which the person commenced, or is intended to commence, working at the establishment or for the purposes of the agency;
(e)information as to the person’s qualifications, experience and skills in so far as is relevant to the work that the person is to perform;
(f)a statement by the applicant that he is satisfied as to the authenticity of the qualifications, and has verified the experience and skills that are referred to in sub-paragraph (e);
(g)a statement as to –
(i)the suitability of the person’s qualifications for the work that the person is to perform;
(ii)whether the person has the skills necessary for such work;
(iii)the person’s fitness to work, and have regular contact, with service users;
(h)a statement by the person as to the state of his physical and mental health;
(i)a statement by the applicant that the person is physically and mentally fit for the purposes of the work which he is to perform;
(j)a statement by the applicant as to whether he is satisfied as to the person’s identity, the means by which he so satisfied himself and whether he has obtained a copy of the person’s birth certificate;
(k)confirmation by the applicant that he has a recent photograph of the person;
(l)a statement by the applicant that he has obtained two references relating to the person and that he is satisfied as to the authenticity of those references;
(m)details of any criminal offences of which the person has been convicted, including details of any convictions which are spent within the meaning of the Rehabilitation of Offenders (Northern Ireland) Order 1978 and which may be disclosed by virtue of the Rehabilitation of Offenders (Exceptions) Order (Northern Ireland) 1979, and, in relation to each such offence, a statement by the person –
(i)as to whether in his view the offence is relevant to his suitability to care for, train, supervise or be in sole charge of any person and, if so,
(ii)as to why he considers that he is suitable to perform the work in which he is to be employed;
(n)details of any criminal offences in respect of which he has been cautioned by a constable and which, at the time the caution was given, he admitted.