Primary Care Clinic (PCC) ā Affiliate Application Instructions for Initial, and Change of Location (CHOL) Applicationsā
To receive a health facility license in California, an applicant must fully complete the required application forms and submit them with all of the identified supporting documents.
These instructions assist in preparing a PCC ā Affiliate Initial, or CHOL application for licensure.
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
Review Process
CAB receives an application packet and assigns an application ID number in the Electronic Licensing Management System. CAB conducts a comprehensive review of the application packet to validate receipt of all required forms and supporting documents, ensures compliance with state and federal requirements, and requests the application packet fee.
CAB completes the review process, sends the application packet to the district office, and issues the state license.
Payments
Payment in full is due upon request by the Department. Make checks payable to āCalifornia Department of Public Health.ā
Payment of outstanding license renewal fees and submission of a license renewal application are required prior to issuance of a license.
Application fees change annually. Check the currentā
application feeā on the Licensing and Certification website.
Submission of Applications
Submit completed application packets and payments to:
California Department of Public Health
Licensing and Certification Division
Centralized Applications Branch
P.O. Box 997377, MS 3207
Sacramento, CA 95899-7377ā
If you have questions, please navigate to the Centralized Applications Branch (CAB)ā Contact Pageāāā.ā