Intermediate Care Facility Change of Ownership Application Packet

A state license is required to operate an Intermediate Care Facility (ICF) in California, which are defined as:

An ICF is “a health facility that provides inpatient care to ambulatory or non-ambulatory patients who have recurring need for skilled nursing supervision and need supportive care, but who do not require availability of continuous skilled nursing care,” pursuant to Health and Safety Code (HSC) section 1250(c).

To apply for a Change of Ownership, you must complete the required application packet.

How to Apply

An applicant must submit a completed application packet to the Centralized Applications Branch (CAB). The provider instructions are a resource to guide you through the process. The provider checklist identifies the required forms and supporting documents needed to apply for to apply for licensing and certification. 

Please refer to the following links to get started:

• Provider Instructions (PDF)
  
• Provider Checklist​​ (PDF)

Where to Submit Applications

Submit completed application packets to the CAB at the address listed below. Do not send any completed application packets, forms, or supporting documents to the local CDPH, District Office.

          California Department of Public Health
          Licensing and Certification Program
          Centralized Applications Branch
          P.O. Box 997377, MS 3207
          Sacramento, CA 95899-7377​