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WWW.DPW.state.pa.us GROUP LIVING ARRANGEMENT INSTITUTION STATUS NOTICE To: (Service Provider) From: (Executive Director) (County Assistance OFCE) Facility/ Residence: (Name) (Address) has been approved
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A group living arrangement institution is a facility where multiple individuals reside together and receive care or support services.
The person or entity responsible for managing the group living arrangement institution is required to file.
The group living arrangement institution form can be filled out online or submitted via mail with all the required information.
The purpose of the group living arrangement institution form is to provide information about the facility and the individuals residing there.
Information such as facility name, address, services provided, number of residents, and contact information must be reported.
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