The Licensing and Certification Program’s Centralized Applications Unit (CAU) was established to centralize the processing of facility applications (initial and change of ownership) for state licensure and federal certification.  The mission of the Centralized Applications Unit is to ensure standardization of the facilities licensure application process and to ensure the review of these applications is done in a consistent manner.  The unit is responsible for reviewing initial and change of ownership (CHOW) applications for licensure of the health facilities listed below. This entails identifying and ensuring that required application information, as required by laws and regulations, is included on all departmental forms. Secondly, an investigation and evaluation of prospective licensees’ current and past compliance history is completed to ensure that all Californians will receive the highest quality medical care possible.

Clinic, Skilled Nursing, and Intermediate Care Facilities Application Forms

Home Health Agency Forms

Management Company

FOR ALL OTHER FACILITY TYPES NOT LISTED, PLEASE CONTACT YOUR LOCAL DISTRICT OFFICE: http://www.dhs.ca.gov/lnc/org/default.htm

Health Facility License and Renewal Fees

Frequently Asked Questions

CHECKS SHOULD BE MADE PAYABLE TO THE “DEPARTMENT OF HEALTH SERVICES” AND MUST ACCOMPANY THE REQUIRED FORMS BEFORE YOUR APPLICATION WILL BE PROCESSED.

How to Contact the Centralized Applications Unit:

CAU may be contacted by phone at (800) 236-9747 (press 1) or by e-mail at CAU@dhs.ca.gov

Facility Descriptions

Community Clinic
Is operated by a tax-exempt nonprofit corporation which is supported and maintained in whole or in part by donations, bequests, gifts, grants, government funds or contributions, which may be in the form of money, goods, or services. Patients pay based on their ability to pay, utilizing a sliding fee scale. Reference H&SC 1204(a)(1)(A).

Free Clinic
Is operated by a tax-exempt, nonprofit corporation supported in whole by voluntary donations, bequests, gifts, grants, government funds or contributions that may be in the form of money, goods, or services. There is no direct charge to the patient for services rendered or for drugs, medicines, appliances, or apparatuses furnished. Reference H&SC 1204(a)(1)(B).

Clinic Exemption List
http://www.leginfo.ca.gov/

1. Click ‘California Law’
2. Click ‘Health & Safety Codes’
3. Enter ‘1206’ as a keyword

Skilled Nursing Facility
A health facility which provides skilled nursing care and supportive care to patients whose primary need is for availability of skilled nursing care on an extended basis.
Reference H&SC 1250(c).

Intermediate Care Facility for Developmentally Disabled – Nursing
A facility with a capacity of four to 15 beds which provides 24-hour personal care, developmental services, and nursing supervision for developmentally disabled persons who have intermittent recurring needs for skilled nursing care but have been certified by a physician and surgeon as not requiring continuous skilled nursing care. The facility shall serve medically fragile persons who have developmental disabilities or demonstrate significant developmental delay that may lead to a developmental disability if not treated. Reference H&SC 1250(h).

Intermediate Care Facility for Developmentally Disabled – Habilitative
A facility which has a capacity of four to 15 beds which provides 24-hour personal care, habilitation, developmental, and supportive health services to 15 or fewer developmentally disabled persons who have intermittent recurring needs for nursing services, but have been certified by a physician and surgeon as not requiring availability of continuous skilled nursing care. Reference H&SC 1250(e).

This page last updated 07/29/2005