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HEALTH CARE FACILITY LICENSING AND CERTIFICATIONā€‹

 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 Numberā€‹ā€‹ā€‹ā€‹ā€‹ā€‹ā€‹

Intermediate Care Facilities for the Developmentally Disabled-Continuous Nursing

Application Instructions for Change of Certificationā€‹

To request and submit changes to a licensed facility in California, complete the required application forms and submit them with all the identified supporting documents. The Centralized Applications Branch (CAB) will not process incomplete applications.
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These instructions assist in preparing an ICF/DD, ICF/DD-H, ICF/DD-N, and ICF/DD-CN report of change application packet for a Change of Certification (CHOC).ā€‹

Please read each required application form carefully and:

  • Provide all requested supporting documents
  • Retain a copy of the completed application forms and supporting documents ā€“ CAB may contact the applicant and will refer to the information providedā€‹ā€‹ā€‹

Review Process

CAB receives an application packet and assigns an application ID number in the Electronic Licensing Management System. A CAB analyst reviews the application packet to validate receipt of all the required forms and supporting documents. Application packets missing forms and/or supporting documents are incomplete and may result in a delay in processing. ā€‹

Submission of Applicationsā€‹

Submit completed application packets to:

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

If you have any questions, please contact CAB at (916) 552-8632 or by e-mail at CAB@cdph.ca.gov.
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