CHECKLIST FOR A RELOCATION – PEDIATRIC DAY HEALTH CARE (PDHC) FACILITY

Geographical Address Change Process

A PDHC that intends to change the physical address of its geographic location is required to have plan review approval, approval from Office of State Fire Marshall, approval from the Office of Public Health, and an on-site licensing survey by Health Standards Section must be conducted prior to relocation.

Facility Need Review:

  1. a PDHC provider undergoing a change of location in the same licensed service area shall submit a written attestation of the change of location and the department shall re-issue the FNR approval with the name and new location;
  2. a PDHC provider undergoing a change of location outside of the licensed service area shall submit a new FNR application and appropriate fee and undergo the FNR approval process;
  3. FNR approval of a licensed provider shall expire if the provider is moved or transferred to another party, entity or location without application to and approval by the FNR Program.

The relocation application packet shall include:

  1. A written “notice of intent” to relocate should be submitted to Health Standards Section at the same time the plan review request is submitted to the Office of the State Fire Marshal’s describing the details of the location change;
  2. A completed Pediatric Day Health Care licensure application (HSS Form)
  3. A non-refundable licensing fee of $600 as relocation of the facility’s physical address results in a new anniversary date and the full licensing fee must be paid  (Payment Procedure website)
  4. A copy of the approval letter of the architectural facility plans from the Office of the State Fire Marshal (OSFM) Health Care licensing plan review internet site - http://sfm.dps.louisiana.gov/pr_healthcare.htm   OSFM plan review contact information: Phone 225-925-4920 or Fax 225-925-4414
  5. A copy of the on-site inspection report with approval for occupancy by the Office of the State Fire Marshall
  6. A copy of the health inspection report with approval of occupancy from the Office of Public Health
  7. Proof of financial viability comprised of the following:
    1. A letter of credit issued from a federally insured, licensed lending institution in the amount of at least $100,000;
    2. Proof of general and professional liability insurance of at least $300,000;
    3. Proof of worker’s compensation insurance;
  8. A floor sketch or drawing of the premises to be licensed;
  9. 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.

The provider receive written notification of the process to follow in order to schedule the onsite relocation inspection, once all required and approved documentation is.  The provider is not to move into the new location until given written approval from the department to do so.