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HEALTH CARE FACILITY LICENSING AND CERTIFICATION​​​​

 Contact Us

Phone: (916) 552-8632
Email: CAB@cdph.ca.gov     

For application status requests, please include the following in your email:

  • Name of Facility or Agency
  • License or Facility/Agency # (if applicable)
  • Address
  • Facility or Provider Type
  • Date Documentation Sent
  • Contact Number​​​​​​

General Acute Care Hospitals and Acute Psychiatric Hospitals

Change of Services - Mobile Unit(s)

Required Documents

Online Application PDF Form
  • Embedded and generated by online system
Addition or Reactivation of Mobile Unit
  • Documentation/letter approval from the local planning/zoning agency)
  • Department of Health Care Access and Information (HCAI) Certificate of Occupancy (CO), Construction Final (CF), or Substantial Completion (SC) (Not applicable if the pad has previously been approved by HCAI)
  • Letter verifying the mobile unit is self-contained (if applicable) 
  • Copy of Vehicle registration, including ID, type, and manufacturer (Not applicable for modular units)
  • Copy of Department of Housing & Community Development (HCD) Insignia or “Inspection Approval”
  • STD 850 (PDF)​​ form - Fire Safety Inspection Request or a document that contains the fire inspector’s contact information (name, email, and address)
  • Schematic displaying the location of the mobile unit on the facility property
Helpful Tip:
  • ​Submit a Change of Certification (CHOC) application to update Medi-Cal/Medicare, if applicable.
Replacement of a Mobile Unit
  • ​​Letter verifying the mobile unit is self-contained (if applicable) 
  • Copy of Vehicle registration, including ID, type, and manufacturer (Not applicable for modular units)
  • Copy of Department of Housing & Community Development (HCD) Insignia or “Inspection Approval”
  • STD 850 (PDF) form - Fire Safety Inspection Request or a document that contains the fire inspector’s contact information (name, email, and address)​
Removal of a Mobile Unit:
  • ​No uploaded documentation required


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