What is one of the steps the board may require from the applicant at their expense?

The correct answer identifies fingerprinting by a law enforcement agency as a required step for the applicant at their expense. This process serves as a critical measure for ensuring the safety and well-being of residents in nursing facilities. Fingerprinting allows for a thorough background check, including a review of criminal history, which is essential in a field where individuals are entrusted with the care of vulnerable populations.

Many states, including Louisiana, mandate this procedure as part of the licensing process for nursing facility administrators to prevent individuals with disqualifying criminal history from obtaining licenses. This requirement aligns with the state’s commitment to safeguarding the health and safety of individuals in care facilities.

The other options, while relevant in various contexts, do not specifically align with the state's regulatory requirements for licensing in the same manner as fingerprinting does. For example, while background checks through personal references are valuable, they may not have the same level of scrutiny or verification rigor as fingerprint checks conducted by law enforcement agencies. Likewise, residency verification and health examinations are important in their contexts but are not universally mandated as a step in the same regulatory framework concerned with criminal background assessment.