Nina’s Safe Haven LLCDoing Business As: Nina’s HavenIndependent Living Program – Resident Packet Logo
  • Nina’s Safe Haven LLCDoing Business As: Nina’s HavenIndependent Living Program – Resident Packet

  • 1. Mission Statement

    Nina's Safe Haven provides a supportive, independent living environment for individuals reentering society. Our mission is to empower residents to rebuild their lives with dignity, take ownership of their journey, and thrive in a safe, structured community.

    2. Vision

    To offer respectful, self-directed housing for individuals transitioning from incarceration or hardship—a peaceful space to heal, grow, and achieve independence.

    3. Who We Serve

    - Formerly incarcerated adult women and men
    - Individuals with disabilities seeking supportive housing
    - Residents who need a stable, self-directed environment

  • 4. Program Overview
    - Independent Living: Residents manage daily routines independently while following community guidelines.
    - Length of Stay: Typically 6–12 months with individualized progress planning.
    - Services Provided:
     • Safe, structured housing environment
     • Optional grocery transportation service (additional fee)
     • Shared facility maintenance
     • On-site laundry access ($      monthly fee)

  • 5. Eligibility

    - 18 years or older
    - Justice-involved and/or with a qualifying disability
    - Willing and able to live independently
    - Agreement to follow community guidelines

  • 6. Program Fees
    - One-time Program Fee: $150 (non-refundable; secures placement and covers administrative processing)

    - Monthly Program Fee: $   *   (not considered rent)

    - Laundry Fee: $   *     per month (if using on-site facilities)

    - Due Date: All monthly fees are due by the     *     of each month.

    - Late Policy: $15 late fee after the 5th. If unpaid after 10 days without arrangements, discharge may occur.
    *

  • 7. House Rules & Expectations

    General Conduct:
    - Treat yourself and others with respect.
    - Keep personal and shared areas clean.
    - Manage responsibilities as an independent resident.

    No-Guest Policy:
    - No visitors are allowed for privacy and safety.

    Substance Policy:
    - Zero tolerance for drugs and alcohol.

    Smoking:
    - Smoking is allowed only in designated backyard areas.
    Cameras & Safety:
    - Security cameras are installed in common areas. Tampering is prohibited.
    Meetings:
    - Attendance at monthly house meetings is required.
    Laundry:
    - Laundry use is limited to once per week.

    Housekeeping Expectations

    Cleanliness Requirement: Residents must clean up after themselves and maintain shared areas.

    Enforcement: If a resident fails to maintain cleanliness, a warning will be issued.

    If not corrected within five (5) business days, the resident may be discharged.

    Weekly Cleaning Sign-Up: Residents must sign up weekly for cleaning duties using the household sign-up sheet.

    8. Move-In Process

    Steps:
    1. Intake Application Submission (online only)
    2. Acceptance and move-in scheduling
    4. Orientation, house tour, and guidelines review

    What to Bring:
    - Valid ID, prescriptions, and basic hygiene products
    - Minimal belongings (1–2 bags)

    Items Not Allowed:
    - Weapons
    - Drugs or paraphernalia
    - Excess or unauthorized belongings

    9. Resident Responsibilities

    - Live independently without daily supervision
    - Prepare your own meals
    - Attend monthly house meetings
    - Allow for random check-ins and drug testing
    - Contact staff immediately in emergencies
    - Store medications in a personal lockbox
    - Respect all community guidelines
    - Maintain a clean living space

    10. Mail Policy

    Nina’s Haven is a month-to-month program, not a permanent residence. Residents may not receive mail or packages at the property. All mail must be sent to a P.O. Box or alternate address.

  • 12. Independent Living Program Fee Agreement – Month-to-Month Residency

  •  - -
  • Monthly Program Fee
    The resident agrees to pay a monthly program fee of $   *   (not considered rent) for participation in the independent living program. This fee is due on the 1st of each month, unless otherwise agreed:
    ☐ Other agreed due date:   *   

  • If a resident moves in after the 1st of the month, the full monthly program fee is still due for that month unless a different amount is agreed upon in writing.

    3. Late Payment Policy

    If the monthly program fee is not paid in full by the 10th of the month, the resident may be discharged from the program immediately.

     


    4. Month-to-Month Terms

    Continuation in the program is based on compliance with all rules and timely payment of program fees. Nina’s Haven reserves the right to terminate participation at any time if terms are not met.

     


    5. Mail Delivery Policy

    As Nina’s Haven is a month-to-month independent living program and not a permanent residence, residents are not permitted to have mail, packages, or deliveries sent to the property.

     

     

     

  • Acknowledgment & Signature

    I understand and agree to the terms above regarding my monthly program fee and participation in the program. I acknowledge that this fee is not considered rent, and failure to pay may result in immediate discharge from the program.

     

     

     

  • Powered by Jotform SignClear
  •  - -
  • 13. Three-Warning Policy To maintain a respectful, safe, and supportive environment, Nina’s Haven follows a three-warning system:

    First Warning: A written notice will be issued for violations of house rules or program expectations.
    Second Warning: A second written notice will be issued for repeated or new violations.
    Third Warning: Upon receiving a third written notice, the resident will be terminated from the program immediately and required to vacate the premises.

     

    Note: Some violations — such as violence, drug/alcohol use, theft, or other serious misconduct — may result in immediate termination without warnings.

    Acknowledgment & SignatureI have read, understand, and agree to comply with the Nina’s Haven Three-Warning Policy. I understand that after receiving three written warnings, I will be terminated from the program

  • Powered by Jotform SignClear
  •  - -
  • Common Areas After Hours

    • Common areas (living room, dining room, kitchen) are for daytime and evening use only.

    • Sleeping in common areas is not allowed unless approved by staff for a temporary reason.

    • Please turn off all lights, TVs, and electronics when not in use to save energy and ensure safety.

    • If you need assistance or a change in sleeping arrangements, notify staff immediately

    ·       I agree to be on camera while on the property for safety and security purposes.

  • Powered by Jotform SignClear
  •  - -
  • Quiet Hours

    ·       Quiet Hours are from 10:00 PM to 7:00 AM.

    ·       During this time, please keep noise to a minimum out of respect for all residents.

    ·       This includes loud conversations, music, television, and any disruptive activity.

    ·       If you are not working during these hours or have not communicated a special need to staff, you must follow Quiet Hours.

    ·       Residents who work late or have approved exceptions must still be mindful of noise.

  • Powered by Jotform SignClear
  •  - -
  • NINA’S SAFE HAVENLIABILITY WAIVER & RELEASE OF CLAIMS

  •  - -
  •  


    Acknowledgement of Risks

    Resident understands that living in a shared housing environment carries certain risks, including but not limited to accidents, injuries, illnesses, loss of personal property, or other incidents that may occur within or outside the premises.

    Release of Liability

    Resident hereby releases, waives, and discharges Nina’s Safe Haven, LLC, its owner(s), staff, contractors, and representatives from any and all liability, claims, demands, actions, or causes of action of any kind, including those for personal injury, illness, accidents, or death, whether caused by negligence or otherwise, that occur while residing in the home or participating in any activities related to the program. Resident understands and agrees that this release applies even if the injury, illness, or accident occurs on the property, during program activities, or as a result of conditions in the home.

    Indemnification

    Resident agrees to indemnify and hold harmless Nina’s Safe Haven, LLC from any loss, liability, damage, or costs, including court costs and attorney fees, that may be incurred due to their own acts, omissions, or conduct while residing in the home.

    Medical Treatment

    Resident understands that Nina’s Safe Haven, LLC is not responsible for providing medical care. In the event of an emergency, staff will contact emergency services, and any associated costs will be the Resident’s responsibility.

    Personal Belongings

    Nina’s Safe Haven, LLC is not responsible for any lost, stolen, or damaged personal property. Resident is encouraged to secure personal items.

    Understanding & Agreement

    Resident affirms that they have read this Agreement, understand its contents, and sign it voluntarily. Resident understands this is a legally binding release of liability.

  • Powered by Jotform SignClear
  •  - -
  • Emergency Contact Information 

  • Required Documentation Section

  • Please upload the following documents with this form. These documents are required for your file at Nina’s Haven:

     


    Valid Photo ID (State ID, Driver’s License, or Passport)

     

  • Browse Files
    Drag and drop files here
    Choose a file
    Cancelof
  • Insurance Card (Front and Back)

  • Browse Files
    Drag and drop files here
    Choose a file
    Cancelof
  • Should be Empty: