Cinco Charities Temporary Housing Guidelines
Legal Notice (For guests to review, signature pages are found with application)
Please read, acknowledge your understanding of, and agreement to, the conditions of your application with Cinco Charities® for a personal license to use Cinco Charities Ballard House as temporary housing. By initialing to the left and signing below; you are acknowledging that you understand and are agreeing to all of the Cinco Charities House Guidelines.
All Guests agree to indemnify and hold Cinco Charities, its officers, directors, agents and assigns and the owner of Cinco Charities House harmless from any and all liability of any kind whatsoever arising out of or in any way connected with their stay at any Cinco Charities facility.
You understand, acknowledge and agree that your use of Cinco Charities Ballard House or other lodging is a personal license only that may be terminated at any time by Cinco Charities®. Your occupancy of Cinco Charities Ballard House is not a lease nor does it constitute a tenancy of any kind. If you fail to vacate Cinco Charities Ballard House when requested, you will be trespassing.
Application and Referral
All referrals must be confirmed and approved by a Katy or Houston area (1) hospital or medical facility, (2) a physician or social worker, or (3) a community service or outreach organization.
The Cinco Charities® Housing Program is reserved for patients (“Guests”) and their families (“Caregivers”) who must travel to the Katy or Houston area for treatment, regardless of whether services are considered inpatient or outpatient.
Guests must have a back-up plan. All services depend on the availability of housing accommodations.
All applications for services must be completed and received no later than seven (7) days prior to housing need. Complete application must provide all appropriate Guest and Caregiver information, Signature of Social Worker or Referring Physician with contact numbers, and Specific Dates of treatment.
The length of stay approved will be determined by Cinco Charities® after review and verification of dates submitted for housing with a maximum of 30 days approved initially, with the possibility of extending up to a maximum of 90 nights, dependent upon availability. Validation is at the discretion of Cinco Charities® and unconfirmed treatment will result in dismissal from Cinco Charities® Housing assistance.
Each stay requires the completion of a new Application and Housing Guidelines and approval from Cinco Charities®.
All Patients, Caregivers, Family Members and Guests will be subject to background checks and verification of all information provided.
Approved Guests must notify Cinco Charities® at least 24 hours in advance of their arrival and departure to confirm dates and times at 281-717-4670.
If there is a change in travel plans, it is the Guest’s responsibility to notify Cinco Charities® as soon as possible and not later than 24 hours prior to scheduled arrival at 281-717-4670. Failure to make notification may cause Guest to forfeit the ability to receive future services.
It is the responsibility of the Guest to notify Cinco Charities® no less than 24 hours before any absence during an approved stay. If the Guest is absent for more than three days in a seven day period the reservation will be cancelled and Guest will need to re-apply for a new stay period, unless Cinco Charities® has previously approved a separation in the stay.
Conditions Guest and Caregiver Must Accept
Guests or family members who fail to adhere to the Cinco Charities® Ballard House Guidelines will have their license terminated and are subject to immediate dismissal from the housing provided and may become ineligible for future housing assistance. A Guest and his/her Caregiver may have his/her license terminated and be asked to leave the housing provided if the Guest, Caregiver, a family member, friend or other invitee fails to adhere to the Housing Guidelines.
In order to be approved for housing a Guest who is receiving treatment must have a Caregiver.
All Caregivers must be 18 years of age or older.
Guests are responsible for all of their own transportation.
All personal charges, including but not limited to phone calls, room damages, movies, entertainment or any other amenities that have a fee and any items damaged or taken from the facility are the Guest’s sole responsibility and may be charged against the deposit put up by the Guest. The Guest’s deposit will not be returned or if on a credit card, released until Cinco Charities® has inspected the Premises for damages after the stay, and determined if there are any charges against, in connection with the stay for which the Guest is responsible. If such charges are found, then Cinco Charities® will provide a written statement outlining the same to the Guest.
The Ballard House Rules
Check-In Time will be by appointment between 9:00 am and 7pm Monday through Friday. Saturday and Sunday check in is between noon and 5 pm. There will be no late check-ins. Keys will be returned as instructed upon check-out.
Upon or prior to arrival, Cinco Charities® will collect a $100 deposit in check or credit card to be held until Guest checks out and the premises inspected for unpaid charges, damages or loss. A current photo ID of all persons is required for Check-in.
This is a Non Smoking Facility. Smoking in any room is prohibited. Smoking is permitted in one designated area. No grace here; if you choose to ignore this guideline, you will have automatically checked yourself out of The Ballard House.
Pets, alcohol and any illegal substances are not permitted on premises.
Prescription medications must be locked in your room at all times.
No firearms or weapons of any kind are allowed on premises, including, without limitation, concealed weapons that are licensed.
As a matter of respect and sanitation, guests, caregivers and visitors are required to dress in the common areas in a matter that will not cause others any level of discomfort or embarrassment. Other guests, maintenance individuals and Cinco Charities® Board members may visit the home at any time.
No more than one vehicle per Guest will be allowed.
A fully equipped kitchen is available for your use. Guests must provide their own food and keep the kitchen clean at all times. Do not leave dishes in the sink or uncovered foods in the refrigerator, pantry or countertops. Clean all items used and remove all food before checkout.
Guests must dispose of their own trash in the onsite dumpster.
Use of the washing machines and dryers are available free of charge. Guest must provide laundry detergent, bleach and fabric softeners.
TV, local phone and Internet will be available in the common living area to share with other house Guests.
Guests must provide all of their own personal hygiene products, hand and bath soap, shampoo, toothpaste, personal cleaning and bathroom products. Remove all personal items before checkout.
Guests are responsible for keeping the home clean during their stay and will be assigned daily chores.
Bedding and towels will be provided upon check-in. Prior to check out the Guest is responsible for cleaning all areas used, including putting all linens and towels in the washer.
Approval by Cinco Charities, Inc.
Cinco Charities® will notify Guest by the preferred contact method indicated by you no later than 24 hours before the requested arrival date whether the application has been approved and lodging is available. If they have not been notified by such time, they should contact Cinco Charities® at 281-717-4670.
The patient’s written permission is required to contact the referral source, physician or hospital to verify your application.
Cinco Charities, Inc. is not responsible for lost, left behind, or stolen items, or for injuries suffered or for accidents on the premises.
Any person who, in the sole opinion of Cinco Charities® has been, is or is likely in the future to be disruptive or harmful to other Guests, the operation of the house, or the environment must vacate the Premises immediately upon the request of Cinco Charities® and failure to do so will result in such person or persons being guilty of trespass.
I understand that I am a Guest of the Cinco Charities Ballard House under a personal license and will vacate the premises immediately if asked to do so by the Cinco Charities® representative. If I fail to leave the house within three (3) days from the date requested. I agree that I will be responsible for and will pay a fee of $150/day for each day thereafter until the Premises are fully vacated. I understand that the $150/day fee constitutes liquidated damages for my failure to leave and agree that it is a reasonable amount to compensate Cinco Charities® for the damages it will suffer as a result of my failure to vacate when requested.
In conjunction with this application, I agree and consent to a background check being performed on me by Cinco Charities or its agent which may include all or some of the following: performing a criminal background check and obtaining such additional background information as Cinco Charities deems necessary. I hereby authorize any party contacted by Cinco Charities, Inc. to furnish all requested information and that a copy of this authorization with my signature shall have the same authority as the original. To the best of my knowledge all information contained in this application is accurate.