Licensing and Certification Program HHA Initial Application Packet Health care Facility Licensing and Certification Forbidden 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 (916) 558-1784, COVID 19 Information Line: "D RH2>KA$C(Hd]-$-| ,8`_ U The provider instructions are a resource to guide you through the process. Initial Licensure/ Renewal - submit license application form, and fee Change of Address Change of Key Personnel Change of Name Change of Ownership Add a Branch Links Complaints - 1-800-327-3419 OASIS Developing an All Hazards Risk Assessment and Emergency Plan Memo CMS Compliant Templates Hazard Vulnerability Analysis (HVA) An applicant for certification as a HHA shall comply with each of the following: You must complete and submit the following to CDPH: an Initial Application (CDPH 283D)(PDF),upon enrollment in the training program and a copy of the Request for Live Scan Service (BCIA 8016) form(PDF). A Home Health Agency may be a public, nonprofit or proprietary agency or a subdivision of such an agency or organization. Sacramento, CA 95814 @ 8vS *Exceptions: Elective Percutaneous Coronary Intervention (ePCI), Sterile Compounding, and Change of Management Company (CHMC) applications are only processed as This could vary depending on the workload of the district office where the home health provider is located. Mail the completed application with appropriate application feesto the HCSB at: California Department of Social Services (916) 558-1784, COVID 19 Information Line: Initial/Primary Care Clinic (PCC): An application is required to establish a license for a primary care clinic. The HHP coordinates the full range of physical health, behavioral health, and community-based long-term services and supports (LTSS) needed by . Please turn on JavaScript and try again. The Health Homes Program (HHP) is desi gned to serve eligible Medi-Cal beneficiaries with complex medical needs and chronic conditions who may benefit from enhanced care managem ent and coordination. Application for Family Care Home License Family Care Home License Fees: $42 Personal Services Agency Application for Personal Services Agency Certification PSA Initial Application Checklist PSA License Fees: $500 for initial certification $350 for annual recertification $350 for a change in an ownership interest of more than 25 percent This program licenses California HMDR facilities and registers Out-of-State HMDR facilities. To file a complaint regarding a state licensed community care facility or child care facility visit our Complaint Hotline Page for contact information and more. Home Health, Home Care, and Hospice Policy and Procedures to guide you - 888-850-6932. Home Health Branch Offices Services are provided by registered nurses, licensed practical nurses, home health aides, and therapists. 869 0 obj <>stream Home Care Services Bureau The cna agency locations can help with all your needs. Please submit a completed Renewal Application (CDPH 283C) (PDF), along with documentation showing your completion of forty-eight (48) hours of In-Service Training/Continuing Education Units (CEUs) within your two (2) year certification period. Please contact the Licensing and Certification Division by calling (916) 322-2911 or by e-mail at LCDQuestions@dhcs.ca.gov for more information. MS 0500 There are three primary types of caregiver roles: companions/homemakers, home care aides/assistants, and medical caregivers such as CNA's and registered nurses. Reset ), an application is hereby made to operate a home health agency as indicated below: 1. MS 0500 744 P Street MS 9-14-90 For information about temporary waivers and suspensions, during the COVID-19 state of emergency, please visit our COVID-19 page. The Interpretive Guidelines merely define or explain the relevant statute and regulations and do not impose any requirements that are not otherwise set forth in statute or regulation. %%EOF which will provide you with the latest job openings, allow you to post a rsum online, find career guidance, search for training and education programs, find information on local employers, etc. (1-833-422-4255). MS 0500 The Sample Application Packet is a visual aid that displays a sample of the completed forms contained in the application packet. Review the HCS 281for application instructions. Espaol, - A home health agency's license to operate expires one (1) year after the date of issuance of . Working at Aya Healthcare: 401 Reviews. Check all that apply: Initial License Change of Ownership (CHOW) Medicare Medi-Cal Each school is led by a Principal, and supported by one of seven Area Office teams. Public agency is an agency operated by a State or local government. Phone: (877) 424-5778 HCSB is also responsible for the Home Care Aide application process and maintenance of the Home Care Aide Registry. A State license is required to operate as a Home Health Agency (HHA) in California. The application process for an initial/PCC is detailed on the CAB website. No more than 42 . Sacramento, CA 95899-7377, For General Public Information: Listed on 2023-03-01. to Default, California Conference of Local Health Officers, Communicable Disease Control And Prevention, Chronic Disease Injury Prevention Agenda 1-5-2017, Chronic Disease Injury Prevention Agenda 2-15-2017, Chronic Disease Injury Prevention Agenda 3-2-2017, Center for Chronic Disease Prevention and Health Promotion, Division of Chronic Disease and Injury Control, Tobacco Education and Research Oversight Committee, Preventive Medicine Public Health Residency Program, California Epidemiologic Investigation Service Fellowship Program, California Stroke Registry-California Coverdell Program, Guidelines, Resources, and Evidence-Based Best Practices for Providers, Chronic Disease Surveillance and Research Branch, California Comprehensive Cancer Control Program, California's Comprehensive Cancer Control Plan, Domestic Violence/Intimate Partner Violence, Child Passenger Safety (CPS) In California, Drowning Prevention: Toddler Pool and Spa Safety, Nutrition Education and Obesity Prevention Branch, SNAP-Ed Guidance for Local Health Departments, Division of Environmental and Occupational Disease Control, Childhood Lead Poisoning Prevention Branch, Environmental Health Investigations Branch, Community Participation & Education Section, About the Environmental Health Laboratory, CDPH-Approved Cholinesterase Laboratories, Contact the Environmental Health Laboratory, Occupational Health Branch Programs and Activities, Occupational Health Branch Publications & Videos, What's New at the Occupational Health Branch, Work-Related Valley Fever (Coccidioidomycosis), Occupational Health Watch April 2017: Spotlight on Skylight Falls for Workers Memorial Day, Occupational Health Watch July 2016: August Is Valley Fever Awareness Month, Substance and Addiction Prevention Branch, FDLB Chemistry and Microbiology Client List, Abused Substances Analysis Section (ASAS), Division of Radiation Safety and Environmental Management, Radiologic Technology Certification Committee, Certificates, Licenses, Permits and Registrations, Genetic Disease Screening Program Publications, GDSP Notice Of Information And Privacy Practices, Partnership with Perinatal Quality Foundation, Education Resources for Individuals and Families, Maternal, Child and Adolescent Health Division, Program Consultants and Contract Managers, Stories from the Adolescent Family Life Program, Adolescent Sexual Health Education Program, Where We Are: Local BIH Sites and Coordinators, Evaluation of the California Black Infant Health Program, Program Evaluation: Intermediate Outcomes Among Prenatal Group Model Participants, Program Evaluation: Services Received and Services Provided During Prenatal Group, Program Evaluation: Participant Participant and Staff Perceptions about the Program, SisterStory: Stories from Black Infant Health, Program Evaluation: Contextual Conditions that Supported the Implementation of the Prenatal Group Model, Breastfeeding Sites and Local Coordinators, Guidelines and Resources for Community Partners, Breastfeeding Model Hospital Policy Recommendations, Lactation Accommodation: For Child Care Providers, Lactation Accommodation: For Community Partners, In-Hospital Breastfeeding Initiation Data, Lactation Accommodation Laws for Workplace, Jails and School, California Statewide Home Visiting Needs Assessment, Evidence-Based Home Visiting Models in California, California Personal Responsibility Education Program, CA PREP Questions and Answers for 2018 RFA, CA PREP Program Consultants and Contract Managers, CA PREP Questions and Answers for 2021 RFA, CA-PREP RFA 2021: Public Notice of Intent to Award, CA-PREP RFA 2021: Public Notice of Final Award, Human Stem Cell Research Advisory Committee, I&E Program Consultants and Contract Managers, Local Maternal, Child and Adolescent Health, Emergency Preparedness: Infant and Young Child Feeding, Healthy Weight for Healthy Birth and Beyond, Multiple Factors Affect Birthing Parents Weight, Healthy Weight for Healthy Birth and Beyond Toolkit, Healthy Weight for Healthy Birth and Beyond Data Brief, Perinatal Equity Initiative Public Awareness Campaigns, Regional Perinatal Programs of California, Where We Are: Local RPPC Sites and Coordinators, Resources for Hospital and Health Care Providers, CMQCC Improving Health Care Response to Maternal Venous Thromboembolism, CMQCC Improving Health Care Response to Cardiovascular Disease in Pregnancy and Postpartum, RPPC RFA 2022 Public Notice of Intent to Award, RPPC RFA 2022 Public Notice of Final Award, Sudden Infant Death Syndrome (SIDS) Program, SIDS/SUID Northern California Regional Council, SIDS/SUID Southern California Regional Council, MyStory: Stories from the California SIDS Program, Agreement Funding Applications (MCAH & BIH), Breastfeeding Resources for Health Care Providers, Monitoring Adherence to Healthcare Practices that Prevent Infection, Healthcare Personnel Influenza Vaccination Reporting In CA Hospitals, CA Campaign To Prevent BSI in Hemodialysis Patients, Central Line-associated Blood Stream Infection (CLABSI), Methicillin-Resistant Staphylococcus aureus Bloodstream Infection (MRSA BSI), Vancomycin-resistant Enterococci Bloodstream Infection (VRE BSI), Center for Health Statistics and Informatics, California Marriage License, Registration and Ceremony Information, Vital Records Obtaining Certified Copies of Death Records, Obtaining Vital Records From County Offices, Vital Records Issuance and Preservation Branch, California Marriage License General Information, Marriage Officiant Frequently Asked Questions, HIV/AIDS ADAP Health Insurance Premium Payment Assistance, HIV/AIDS ADAP Medicare Part D Premium Payment Assistance, About the Viral and Rickettsial Disease Lab, CDER Information for Health Professionals, Communicable Disease Emergency Response Program, DCDC Information for Local Health Departments, Sexually Transmitted Diseases Control Branch, VRDL Guidelines for Specimen Collection and Submission for Pathologic Testing, Office of Binational Border Health Publications, Office of Binational Border Health Advisory Group, About the Office of Binational Border Health, Contact the Office of Binational Border Health, Quarterly Binational Epidemiology Meetings, Border Infectious Disease Surveillance - Coccidioidomycosis, Border Infectious Disease Surveillance - Queso Fresco, Border Infectious Disease Surveillance - Mosquito-borne-diseases, Border Infetious Disease Surveillance - Rocky Mountain Spotted Fever, Border Infectious Disease Surveillance - Influenza and Other Respiratory Infections, Emergency and Evacuation Planning Guide for Schools, Tips for Communicating with Students During an Emergency, Know When and How to Shelter-in-Place for Schools, How to Help Students Cope and Deal with Stress, Pandemic Flu Preparedness For Schools - Home, Fusion Center (Strategic Development and External Relations), California Equitable Recovery Initiative (CERI) Q&A, AB 1726 Asian and Pacific Islander Data Disaggregation Brief, CDPH Lifts Rock Crab Health Advisory in Portions of San Mateo County - South of Pillar Point, CDPH Launches Mobile Website for WIC Participants, CDPH Reports Widespread Flu Activity that is More Severe than Last Year, CDPH Fines San Francisco County Facility in Death of Resident, CDPH Fines Los Angeles County Facility in Death of Resident, Lets Get Healthy California Announces Local Innovations to Improve Californias Health, Dungeness Crab Health Advisory Lifted for Remainder of California Coast, Dungeness Crab Health Advisory Lifted in Portions of Mendocino County South of Ten Mile River, CDPH Warns Consumers Not to Eat Sport-Harvested Bivalve Shellfish from San Luis Obispo County, Dungeness Crab Health Advisory Lifted in Portions of Sonoma, Mendocino, Humboldt Counties, CDPH Releases Reports on Healthcare-Associated Infections, Influenza Vaccination Rates Among Healthcare Personnel, CDPH Warns Consumers Not to Eat Sport-Harvested Bivalve Shellfish from Monterey County, CDPH Awarded Grant to Expand Child Safety-Seat Use, CDPH Awarded Grant to Study Motor-Vehicle Crash Injuries, Holiday Travelers Reminded to Take Precautions to Prevent Zika, Local Transmission Confirmed in Ensenada, Mexico, Office of Health Equity - Health Equity Policy & Planning Unit, CDPH Climate Change and Health Equity (CCHE), Office of Health Equity Advisory Committee, Health Research and Statistics Unit (HRSU), CDPH Climate Change and Health Profile Reports, CDPH Climate Change and Health Equity - CalBRACE Project, CDPH Climate Change and Health Vulnerability Indicators, Office of Legislative and Governmental Affairs, Office of Professional Development & Engagement, Meet the Former Interns - Yesenia Posadas, Office of the State Public Health Laboratory Director, California Laboratory Animal Use Approval Program, Complaints Program - Laboratory Field Services, Clinical Laboratory Technology Advisory Committee (CLTAC), Clinical Laboratory Scientist Trainee License, Clinical Chemist Scientist Trainee License, Clinical Cytogeneticist Scientist Trainee License, Clinical Genetic Molecular Biologist Scientist Trainee License, Clinical Hematologist Scientist Trainee License, Clinical Histocompatibility Scientist Trainee License, Clinical Immunohematologist Scientist Trainee License, Clinical Microbiologist Scientist Trainee License, Clinical Toxicologist Scientist Trainee License, Clinical Laboratory Professional Licensing, Renewal of Clinical Laboratory Personnel Licenses & Certificates, en Home Health Agencies in California 6874 home health agencies found. to Default, Registered Environmental Health Specialist, California Health Facilities Information Database, Chronic Disease Surveillance and Research, Medical Marijuana Identification Card Program, Office of State Public Health Laboratory Director, Centers for Disease Control and Prevention, License or Facility/Agency # (if applicable). The Home Care Services Bureau (HCSB) is responsible for licensing Home Care Organizations including processing applications, receiving and responding to complaints and conducting unannounced visits to ensure compliance. A CNA who was permitted to work during the pandemic with expired certification must obtain certification by March 1, 2023. Licensure & Certification Application Form (HS 200) Applicant Individual Information (HS 215A) Application for Medi-Cal Certification as a Primary Care Clinic Provider (HS 269) Administrative Organization Form (HS 309) Affidavit Regarding Patient Money Form (HS 400) Surety Bond Verification (HS 402) Transfer Agreement Form (HS 602) Phone: (916) 552-8632Email: CAB@cdph.ca.gov. California law established the Home Care Services Consumer Protection Act which, as of January 2016, requires Home Care Organizations to be licensed and creates a public online registry for Home Care Aides who have been background checked. Decrease, Reset CABHospitals@cdph.ca.gov. Who we are: La Clnica de La Raza is a community-based health center committed to providing culturally appropriate, high-quality, and accessible health care to the diverse commun to Default, California Conference of Local Health Officers, Communicable Disease Control And Prevention, Chronic Disease Injury Prevention Agenda 1-5-2017, Chronic Disease Injury Prevention Agenda 2-15-2017, Chronic Disease Injury Prevention Agenda 3-2-2017, Center for Chronic Disease Prevention and Health Promotion, Division of Chronic Disease and Injury Control, Tobacco Education and Research Oversight Committee, Preventive Medicine Public Health Residency Program, California Epidemiologic Investigation Service Fellowship Program, California Stroke Registry-California Coverdell Program, Guidelines, Resources, and Evidence-Based Best Practices for Providers, Chronic Disease Surveillance and Research Branch, California Comprehensive Cancer Control Program, California's Comprehensive Cancer Control Plan, Domestic Violence/Intimate Partner Violence, Child Passenger Safety (CPS) In California, Drowning Prevention: Toddler Pool and Spa Safety, Nutrition Education and Obesity Prevention Branch, SNAP-Ed Guidance for Local Health Departments, Division of Environmental and Occupational Disease Control, Childhood Lead Poisoning Prevention Branch, Environmental Health Investigations Branch, Community Participation & Education Section, About the Environmental Health Laboratory, CDPH-Approved Cholinesterase Laboratories, Contact the Environmental Health Laboratory, Occupational Health Branch Programs and Activities, Occupational Health Branch Publications & Videos, What's New at the Occupational Health Branch, Work-Related Valley Fever (Coccidioidomycosis), Occupational Health Watch April 2017: Spotlight on Skylight Falls for Workers Memorial Day, Occupational Health Watch July 2016: August Is Valley Fever Awareness Month, Substance and Addiction Prevention Branch, FDLB Chemistry and Microbiology Client List, Abused Substances Analysis Section (ASAS), Division of Radiation Safety and Environmental Management, Radiologic Technology Certification Committee, Certificates, Licenses, Permits and Registrations, Genetic Disease Screening Program Publications, GDSP Notice Of Information And Privacy Practices, Partnership with Perinatal Quality Foundation, Education Resources for Individuals and Families, Maternal, Child and Adolescent Health Division, Program Consultants and Contract Managers, Stories from the Adolescent Family Life Program, Adolescent Sexual Health Education Program, Where We Are: Local BIH Sites and Coordinators, Evaluation of the California Black Infant Health Program, Program Evaluation: Intermediate Outcomes Among Prenatal Group Model Participants, Program Evaluation: Services Received and Services Provided During Prenatal Group, Program Evaluation: Participant Participant and Staff Perceptions about the Program, SisterStory: Stories from Black Infant Health, Program Evaluation: Contextual Conditions that Supported the Implementation of the Prenatal Group Model, Breastfeeding Sites and Local Coordinators, Guidelines and Resources for Community Partners, Breastfeeding Model Hospital Policy Recommendations, Lactation Accommodation: For Child Care Providers, Lactation Accommodation: For Community Partners, In-Hospital Breastfeeding Initiation Data, Lactation Accommodation Laws for Workplace, Jails and School, California Statewide Home Visiting Needs Assessment, Evidence-Based Home Visiting Models in California, California Personal Responsibility Education Program, CA PREP Questions and Answers for 2018 RFA, CA PREP Program Consultants and Contract Managers, CA PREP Questions and Answers for 2021 RFA, CA-PREP RFA 2021: Public Notice of Intent to Award, CA-PREP RFA 2021: Public Notice of Final Award, Human Stem Cell Research Advisory Committee, I&E Program Consultants and Contract Managers, Local Maternal, Child and Adolescent Health, Emergency Preparedness: Infant and Young Child Feeding, Healthy Weight for Healthy Birth and Beyond, Multiple Factors Affect Birthing Parents Weight, Healthy Weight for Healthy Birth and Beyond Toolkit, Healthy Weight for Healthy Birth and Beyond Data Brief, Perinatal Equity Initiative Public Awareness Campaigns, Regional Perinatal Programs of California, Where We Are: Local RPPC Sites and Coordinators, Resources for Hospital and Health Care Providers, CMQCC Improving Health Care Response to Maternal Venous Thromboembolism, CMQCC Improving Health Care Response to Cardiovascular Disease in Pregnancy and Postpartum, RPPC RFA 2022 Public Notice of Intent to Award, RPPC RFA 2022 Public Notice of Final Award, Sudden Infant Death Syndrome (SIDS) Program, SIDS/SUID Northern California Regional Council, SIDS/SUID Southern California Regional Council, MyStory: Stories from the California SIDS Program, Agreement Funding Applications (MCAH & BIH), Breastfeeding Resources for Health Care Providers, Monitoring Adherence to Healthcare Practices that Prevent Infection, Healthcare Personnel Influenza Vaccination Reporting In CA Hospitals, CA Campaign To Prevent BSI in Hemodialysis Patients, Central Line-associated Blood Stream Infection (CLABSI), Methicillin-Resistant Staphylococcus aureus Bloodstream Infection (MRSA BSI), Vancomycin-resistant Enterococci Bloodstream Infection (VRE BSI), Center for Health Statistics and Informatics, California Marriage License, Registration and Ceremony Information, Vital Records Obtaining Certified Copies of Death Records, Obtaining Vital Records From County Offices, Vital Records Issuance and Preservation Branch, California Marriage License General Information, Marriage Officiant Frequently Asked Questions, HIV/AIDS ADAP Health Insurance Premium Payment Assistance, HIV/AIDS ADAP Medicare Part D Premium Payment Assistance, About the Viral and Rickettsial Disease Lab, CDER Information for Health Professionals, Communicable Disease Emergency Response Program, DCDC Information for Local Health Departments, Sexually Transmitted Diseases Control Branch, VRDL Guidelines for Specimen Collection and Submission for Pathologic Testing, Office of Binational Border Health Publications, Office of Binational Border Health Advisory Group, About the Office of Binational Border Health, Contact the Office of Binational Border Health, Quarterly Binational Epidemiology Meetings, Border Infectious Disease Surveillance - Coccidioidomycosis, Border Infectious Disease Surveillance - Queso Fresco, Border Infectious Disease Surveillance - Mosquito-borne-diseases, Border Infetious Disease Surveillance - Rocky Mountain Spotted Fever, Border Infectious Disease Surveillance - Influenza and Other Respiratory Infections, Emergency and Evacuation Planning Guide for Schools, Tips for Communicating with Students During an Emergency, Know When and How to Shelter-in-Place for Schools, How to Help Students Cope and Deal with Stress, Pandemic Flu Preparedness For Schools - Home, Fusion Center (Strategic Development and External Relations), California Equitable Recovery Initiative (CERI) Q&A, AB 1726 Asian and Pacific Islander Data Disaggregation Brief, CDPH Lifts Rock Crab Health Advisory in Portions of San Mateo County - South of Pillar Point, CDPH Launches Mobile Website for WIC Participants, CDPH Reports Widespread Flu Activity that is More Severe than Last Year, CDPH Fines San Francisco County Facility in Death of Resident, CDPH Fines Los Angeles County Facility in Death of Resident, Lets Get Healthy California Announces Local Innovations to Improve Californias Health, Dungeness Crab Health Advisory Lifted for Remainder of California Coast, Dungeness Crab Health Advisory Lifted in Portions of Mendocino County South of Ten Mile River, CDPH Warns Consumers Not to Eat Sport-Harvested Bivalve Shellfish from San Luis Obispo County, Dungeness Crab Health Advisory Lifted in Portions of Sonoma, Mendocino, Humboldt Counties, CDPH Releases Reports on Healthcare-Associated Infections, Influenza Vaccination Rates Among Healthcare Personnel, CDPH Warns Consumers Not to Eat Sport-Harvested Bivalve Shellfish from Monterey County, CDPH Awarded Grant to Expand Child Safety-Seat Use, CDPH Awarded Grant to Study Motor-Vehicle Crash Injuries, Holiday Travelers Reminded to Take Precautions to Prevent Zika, Local Transmission Confirmed in Ensenada, Mexico, Office of Health Equity - Health Equity Policy & Planning Unit, CDPH Climate Change and Health Equity (CCHE), Office of Health Equity Advisory Committee, Health Research and Statistics Unit (HRSU), CDPH Climate Change and Health Profile Reports, CDPH Climate Change and Health Equity - CalBRACE Project, CDPH Climate Change and Health Vulnerability Indicators, Office of Legislative and Governmental Affairs, Office of Professional Development & Engagement, Meet the Former Interns - Yesenia Posadas, Office of the State Public Health Laboratory Director, California Laboratory Animal Use Approval Program, Complaints Program - Laboratory Field Services, Clinical Laboratory Technology Advisory Committee (CLTAC), Clinical Laboratory Scientist Trainee License, Clinical Chemist Scientist Trainee License, Clinical Cytogeneticist Scientist Trainee License, Clinical Genetic Molecular Biologist Scientist Trainee License, Clinical Hematologist Scientist Trainee License, Clinical Histocompatibility Scientist Trainee License, Clinical Immunohematologist Scientist Trainee License, Clinical Microbiologist Scientist Trainee License, Clinical Toxicologist Scientist Trainee License, Clinical Laboratory Professional Licensing, Renewal of Clinical Laboratory Personnel Licenses & Certificates, en