HEALTH CARE FACILITY LICENSING AND CERTIFICATION

Contact Us

Phone: (916) 552-8632

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

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

Skilled Nursing Facility and Intermediate Care Facility

Application Instructions for Change of Certification

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.

These instructions assist in preparing a SNF and ICF report of change application packet for a Change of Certification (CHOC).

Please read each required application form carefully and:

Provide all requested supporting documents
Retain a copy of the completed application forms and supporting documents – CAB may contact the applicant and will refer to the information provided

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.

Submission of Applications

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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