CITY OF ARCADIA MASSAGE THERAPIST APPLICATION PACKET Arcadia City Hall Arcadia Police Department 240 W Huntington Dr 250 W Huntington Dr Arcadia CA 91007 Arcadia CA 91007 626-574-5430 626-574-5150 Thank you for choosing to do business in the City of Arcadia! This packet contains Ordinance No. 2175, Massage Therapist Regulations, and application forms you will need in order to apply for the Massage Therapist Identification Card and Business License required to conduct massage and acupressure in the City of Arcadia. PLEASE NOTE Massage parlors or establishments are prohibited. Massage therapy shall be purely incidental and secondary to an established business. Massage Therapists may operate at an established medical office, including an office of an acupuncturist, physical therapist, day spa or salon. Each medical office, including that of an acupuncturist, shall be limited to two (2) Massage Therapists at any given time. Hours of operation are 7:00 a.m. to 9:00 p.m. The following step-by-step instructions have been provided to assist you in completing the application process: Apply for the Massage Therapist Identification Card: 1. Review Section 6418.1 Definitions (disqualifying conduct) and Section 6418.15 Denial of Massage Therapist Identification Card to ensure you are qualified to submit an application. 2. The following documents or items are required: a. Written proof that you are eighteen (18) years of age or older. (Driver s License or State issued Identification Card is acceptable proof). b. Two (2) front-face portrait photographs at least two inches (2 ) by two inches (2 ) in size taken within thirty (30) days immediately preceding the date you submit your application. (Passport photos are acceptable). c. Certified copy of your diploma or certification of graduation and transcripts of graduation for completion of five hundred (500) hours of instruction from a recognized school of massage. (See Section 6418.1 for the definition of a recognized school of massage). 1
d. A letter of verification from the owner of the proposed business location, signed and dated, indicating the intent to employ you as a massage therapist. 3. Complete the Massage Therapist Identification Card Application and Request for Live Scan Service Form. 4. Return the completed Massage Therapist Identification Card Application, Request for Live Scan Service Form, the required documents or items listed above (item #2) and the application fee of $265.00 to the Arcadia Police Department. The Police Department will not process incomplete applications. The Police Department will take a complete set of fingerprints on the date you submit your application. Fingerprint cards taken from another agency will not be accepted. The application fee may be paid by check, credit/debit cards or cash and is non-refundable. Processing your application will take at least fifteen (15) business days, unless delayed by fingerprint checking or other facts, which require additional investigation. If the investigation requires processing beyond the fifteen (15) business days, you will be notified of the delay by mail. If your Massage Therapist Identification Card Application is approved: 1. The Police Department will issue and mail your identification card. 2. After receipt of your identification card, complete the Business License Application. 3. Return the completed Business License Application to City Hall, Business License Office, in-person along with your identification card and the license fee of $70.90. The license fee may be paid by check, credit/debit cards or cash. The Business License Office will not process the Business License Application without the Massage Therapist Identification Card. A copy of the identification card will not be accepted. Processing your application will take approximately one week. Your certificate will be mailed upon approval of your Business License Application. PLEASE NOTE You must have your Massage Therapist Identification Card and valid photo identification in your possession and you must display the Business License Certificate on the premises where you have received approval to perform massage therapy. Denial of Massage Therapist Identification Card Application: If your Massage Therapist Identification Card Application is denied, you will be notified of the denial by mail. You will not be eligible to apply again for a minimum of one (1) year from the date the application was denied. 2
CITY OF ARCADIA MASSAGE THERAPIST APPLICATION PACKET Arcadia City Hall Arcadia Police Department 240 W Huntington Dr 250 W Huntington Dr Arcadia CA 91007 Arcadia CA 91007 626-574-5430 626-574-5150 Thank you for choosing to do business in the City of Arcadia! This packet contains Ordinance No. 2175, Massage Therapist Regulations, and application forms you will need in order to apply for the Massage Therapist Identification Card and Business License required to conduct massage and acupressure in the City of Arcadia. PLEASE NOTE Massage parlors or establishments are prohibited. Massage therapy shall be purely incidental and secondary to an established business. Massage Therapists may operate at an established medical office, including an office of an acupuncturist, physical therapist, day spa or salon. Each medical office, including that of an acupuncturist, shall be limited to two (2) Massage Therapists at any given time. Hours of operation are 7:00 a.m. to 9:00 p.m. The following step-by-step instructions have been provided to assist you in completing the application process: Apply for the Massage Therapist Identification Card: 5. Review Section 6418.1 Definitions (disqualifying conduct) and Section 6418.15 Denial of Massage Therapist Identification Card to ensure you are qualified to submit an application. 6. The following documents or items are required: a. Written proof that you are eighteen (18) years of age or older. (Driver s License or State issued Identification Card is acceptable proof). b. Two (2) front-face portrait photographs at least two inches (2 ) by two inches (2 ) in size taken within thirty (30) days immediately preceding the date you submit your application. (Passport photos are acceptable). c. Certified copy of your diploma or certification of graduation and transcripts of graduation for completion of five hundred (500) hours of instruction from a recognized school of massage. (See Section 6418.1 for the definition of a recognized school of massage). d. A letter of verification from the owner of the proposed business location, signed and dated, indicating the intent to employ you as a massage therapist. 3
7. Complete the Massage Therapist Identification Card Application and Request for Live Scan Service Form. 8. Return the completed Massage Therapist Identification Card Application, Request for Live Scan Service Form, the required documents or items listed above (item #2) and the application fee of $265.00 to the Arcadia Police Department. The Police Department will not process incomplete applications. The Police Department will take a complete set of fingerprints on the date you submit your application. Fingerprint cards taken from another agency will not be accepted. The application fee may be paid by check, credit/debit cards or cash and is non-refundable. Processing your application will take at least fifteen (15) business days, unless delayed by fingerprint checking or other facts, which require additional investigation. If the investigation requires processing beyond the fifteen (15) business days, you will be notified of the delay by mail. If your Massage Therapist Identification Card Application is approved: 4. The Police Department will issue and mail your identification card. 5. After receipt of your identification card, complete the Business License Application. 6. Return the completed Business License Application to City Hall, Business License Office, in-person along with your identification card and the license fee of $70.90. The license fee may be paid by check, credit/debit cards or cash. The Business License Office will not process the Business License Application without the Massage Therapist Identification Card. A copy of the identification card will not be accepted. Processing your application will take approximately one week. Your certificate will be mailed upon approval of your Business License Application. PLEASE NOTE You must have your Massage Therapist Identification Card and valid photo identification in your possession and you must display the Business License Certificate on the premises where you have received approval to perform massage therapy. Denial of Massage Therapist Identification Card Application: If your Massage Therapist Identification Card Application is denied, you will be notified of the denial by mail. You will not be eligible to apply again for a minimum of one (1) year from the date the application was denied. 4
ARCADIA POLICE DEPARTMENT 250 West Huntington Dr P O Box 60021 Arcadia CA 91066-6021 Massage Therapist Identification Card Application Last Name First Name Middle AKA s (aliases, other names) Home Address (for past five (5) years) Previous Home Address (if above home address does not cover prior five (5) years) Mailing Address (if different from home address) Home Phone Cell/Pager Business Date of Birth Age Social Security # Place of Birth Gender M F Driver s License of ID # State Exp Date Class Height Weight Hair Eyes Marks, Tattoos (locations) OFFICE USE ONLY Applicant # Circle One: Approved Conditionally Approved Denied Fingerprints taken Y N Photographs rec d Y N Diploma/transcripts rec d Y N Proof of age verified Y N Application fees rec d Y N I D Card issued Y N Intent to employ letter rec d Y N Date Date Received by By 5
Provide exact location where you will be performing massage therapy services: Name of business (if applicable): Address: Phone # List your employment history that covers the prior five (5) years, starting with your most recent employer: To: Name of employer: City: From: Address: State: Phone # Supervisor: Zip: To: Name of employer: City: From: Address: State: Phone # Supervisor: Zip: To: Name of employer: City: From: Address: State: Phone # Supervisor: Zip: List all agencies, boards, cities or licensing authorities that have issued a permit and/or license to you to perform massage therapy services: Date: Name of Agency: City: Phone # Date: Name of Agency: City: Phone # Date: Name of Agency City: Phone # Date: Name of Agency City: Phone # Date: Name of Agency City: Phone # 6
Have you ever had a permit and/or license to perform massage therapy services denied, revoked or suspended by any agency, board, city or licensing authority? YES* NO *If your answer is yes to the above question, complete the following: Date: Name of agency: City: Circle One: Denied Revoked Suspended Reason: Date: Name of agency: City: Circle One: Denied Revoked Suspended Reason: Date: Name of agency: City: Circle One: Denied Revoked Suspended Reason: Are you required to register as a sex offender pursuant to the California Penal Code 290? YES NO List all criminal convictions within the last ten (10) years, including those dismissed or expunged pursuant to Penal Code 1203.4 and pleas of nolo contendre (no contest), excluding minor traffic violations: Date: City: Disposition: Type of Offense: State: 7
Date: City: Disposition: Type of Offense: State: Date: City: Disposition: Type of Offense: State: Indicate your acceptance of each item listed below by initializing in the space provided: I have received a copy of the City of Arcadia Massage Therapist Ordinance. I understand its contents and will comply with all requirements and duties of a massage therapist as set forth in the Massage Therapist Ordinance. I authorize the Chief of Police to conduct an investigation, in such manner as deemed appropriate, and will provide additional information and identification that may be required in order to discover the truth of the matters specified in this application and ascertain whether such application should be approved. I FURTHER UNDERSTAND THAT PURSUANT TO ARCADIA MUNICIPAL CODE SECTION 6418.17, THIS APPLICATION AND/OR MASSAGE THERAPIST IDENTIFICATION CARD MAY BE DENIED, SUSPENDED OR REVOKED FOR THE REASONS SET FORTH THEREIN INCLUDING VIOLATING THE MASSAGE THERAPIST ORDINANCE. I certify under penalty of perjury that the information contained in this application is true and correct to the best of my knowledge. I further understand that the application fee is non-refundable. Date: Signature: 8