Pediatric Day Health Care Facility Initial Licensure Requirements

The following must be submitted to Health Standards Section:

1. a Letter of Intent

2. a copy of the approval letter of the architectural facility plans from the Office of the State Fire Marshal Plan Review;

3. a copy of the on-site inspection report with approval for occupancy by the Office of the State Fire Marshal;

4. a copy of the health inspection report with approval of occupancy from the Office of Public Health;

5. a copy of statewide criminal background checks on all owners and the administrator;

6. Line of Credit ($100,000) from a federally insured lending agency

7. proof of general and professional liability insurance of at least $300,000;

8. proof of worker’s compensation insurance;

9. if applicable, Clinical Laboratory Improvement Amendments (CLIA) certificate or CLIA certificate of waiver;

10. a completed disclosure of ownership and control information form;

11. a letter-sized floor sketch or drawing of the premises to be licensed;

12. qualifications for the Administrator, Director of Nursing, and Medical Director

13. a copy of the Articles of Incorporation

14. a signed Attestation statement from a licensed electrician attesting to the correct installation of a fully functioning generator and that generator is of sufficient wattage to power the facility

15. completed License Application and $600.00 non-refundable fee in the form of a company check, cashier's check or money order, payable to the Department of Health and Hospitals. The Payment Procedure has changed please follow the link for instructions.