Lucas State Office Building, 3rd floor | 321 E 12th St. | Des Moines, Iowa 50319 |
515.281.7102
Iowa law requires that owners, operators, or managers of boarding homes must register their buildings with the Iowa Department of Inspections, Appeals, & Licensing (DIAL).
A boarding home DOES NOT include facilities, homes, or programs regulated by DIAL or the Iowa Department of Health and Human Services (HHS).
Owners, operators, or managers should use this form for the initial registration of their home(s) as well as the annual occupancy report(s) with DIAL.
Do I need to register?
Homes that DO need to register are:
If the premise meets the above criteria, it must be registered and occupancy reports must be filed annually with the department.
Still unsure if you need to register? Have any other boarding home-related questions? Call (515.281.4115) or email the Department of Inspections, Appeals, and Licensing.
Failure to register a boarding home with the department annually will subject the owner, operator, or manager to a civil penalty of up to $500.
Boarding home registration information must be updated any time a change occurs, within 30 days of the occurrence. Boarding home occupancy information can only be updated on an annual basis. These annual updates must include information current as of Dec. 31 and must be submitted by Jan. 31 of the following year.
Assistance with Registration or Occupancy Reports
Owners, operators, or managers of boarding homes who need assistance with the initial registration of their premise or the filing of the annual occupancy report may contact the department's Health Facilities Division at 515.281.4227. Printed registration forms and occupancy reports also may be requested by calling the number listed above.
Reason for registration today
Boarding Home Physical Address
Is the mailing address the same as the physical address?
Mailing Address
This section requires you to submit information regarding the maximum number of available rooms/units in the boarding home, the maximum occupancy allowed, and fire safety information. You are also required to submit information regarding the responsible party for the boarding home. The responsible party is the individual designated as the primary contact with the Department of Inspections and Appeals.
The responsible party may be the real estate owner, lessee, manager, or someone designated as the responsible party by the owner, lessee, or manager.
Which fire safety devices are present and operational in the boarding home?
If known, the number of tenants in the building who require assistance (help/aid) with any of the following activities of daily living (if not known, select "0")
If known, are any other agencies or individuals providing service(s) to the tenants?
Date of last fire inspection by state or local fire marshal, if applicable
Are there any deficiencies?
Does the building have a centralized kitchen in which meals are prepared?
Owner 1 Name
Owner 1 Address
Owner 2 Name
Owner 2 Address
Owner 3 Name
Owner 3 Address
Owner 4 Name
Owner 4 Address
Owner 5 Name
Owner 5 Address
Owner 6 Name
Owner 6 Address
Owner 7 Name
Owner 7 Address
Owner 8 Name
Owner 8 Address
Owner 9 Name
Owner 9 Address
Owner 10 Name
Owner 10 Address
Lessee 1 Name
Lessee 1 Address
Lessee 2 Name
Lessee 2 Address
Lessee 3 Name
Lessee 3 Address
Lessee 4 Name
Lessee 4 Address
Lessee 5 Name
Lessee 5 Address
Lessee 6 Name
Lessee 6 Address
Lessee 7 Name
Lessee 7 Address
Lessee 8 Name
Lessee 8 Address
Lessee 9 Name
Lessee 9 Address
Lessee 10 Name
Lessee 10 Address
Manager 1 Name
Manager 1 Address
Manager 2 Name
Manager 2 Address
Manager 3 Name
Manager 3 Address
Manager 4 Name
Manager 4 Address
Manager 5 Name
Manager 5 Address
Manager 6 Name
Manager 6 Address
Manager 7 Name
Manager 7 Address
Manager 8 Name
Manager 8 Address
Manager 9 Name
Manager 9 Address
Manager 10 Name
Manager 10 Address
Submission number
