Application Instructions for Initial and Change of Ownership (CHOW), and Report of Change (ROC) Applications
To receive a health facility license or report a change to an already licensed health care facility 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 Initial, CHOW, or ROC application for licensure.
Please read each required application form carefully and:
CAB may contact the applicant and will reference the information submitted
Review Process
CAB receives an application packet and assigns an application ID number in the Electronic Licensing Management System. CAB conducts a prescreen review of the application packet to confirm receipt of all required forms and supporting documents and will request the application packet fee. For CHOW and ROC applications, CAB validates the health facility license is active. To prevent a license from expiring, submit a license renewal application and license renewal fee.
Once prescreen is complete and the application packet fee is received, CAB will conduct a comprehensive review to ensure compliance with state and federal requirements.
CAB completes the review process and sends the application packet to the district office.
As required, an onsite survey will be conducted to validate compliance with licensing requirements. Upon completion, the district office will notify CAB to issue the health facility license.
Payments
Do not submit payment until requested by CAB. Payment in full is due upon request by the Department. Online payment instructions are provided upon payment request. Make checks payable to “California Department of Public Health.”
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. Refer to the current
fee schedule on the Licensing and Certification website.
Submission of Applications
Submit completed application packets and checks to: