Psychiatric Residential Treatment Facilities (PRTF) Initial Licensure 

The following forms and fees must be submitted to Health Standards Section:

  1.  Initial application and non-refundable fee (click here)
  2. Copy of approval letter of Architectural Review (AR) of the facility plans from the Office of the State Fire Marshal (OSFM)
  3. Copy of approval letter of Department of Health (DH) facility plans review from the Office of the State Fire Marshal (OSFM)
  4. Cautionary codes from the Office of the State Fire Marshal (OSFM)
  5. Attestation for compliance with plan review Cautionary Codes
  6. Copy of on-site inspection report with approval for occupancy by the Office of the State Fire Marshal
  7. Copy of health inspection report with approval for occupancy from the Office of Public Health (OPH)
  8. Copy of statewide criminal background checks on all individual owners with 5% or more owner interest in the PRTF entity, and on all members of PRTF's board of directors, if applicable, and administrators;
  9. Proof of financial viability, comprised of the following:
    a.  line of credit issued from a federally insured, licensed lending institution in the amount of at least $100,000
    b.  general professional liability insurance of at least $300,00; and
    c.  worker's compensation insurance
  10. Floor sketch or drawing of the premises to be licensed