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EDMUND G. BROWN JR.
Governor

Health and Human Services Agency
California Department of Public Health


AFL 18-18
April 17, 2018


TO:
Intermediate Care Facilities
Management Companies
Primary Care Clinics
Skilled Nursing Facilities

SUBJECT:
Online Licensing/Certification Application Process



ā€‹All Facilities Letter (AFL) Summary

  • This AFL announces the new online licensing/certification application process for intermediate care facilities (ICFs), management companies (MCs), primary care clinics (PCCs), and skilled nursing facilities (SNFs).
  • This AFL provides a general overview of the online licensing/certification application process and describes how to register and apply online.

The California Department of Public Health (CDPH), Centralized Applications Unit (CAU) has implemented an online licensing/certification application process for ICFs, PCCs, and SNFs requesting initial licensing approval and MCs requesting initial approval. Providers should continue submitting all report of changes and change of ownership applications via hard copy. Refer to the CAU website for ongoing updates regarding CDPHā€™s implementation of the online licensing/certification application process and the inclusion of additional provider types.

To use the online licensing/certification application process, providers must create a username and password and complete all required facility, personal, and administrative information. Detailed instructions for registering and submitting an application are available in the ā€œL&C Application User Guide for Providers.ā€

After successfully submitting an online application, the system sends a confirmation e-mail with an identification number (Tracking ID number) to the providerā€™s designated point of contact. Providers should use the Tracking ID number when contacting CAU about their application. The confirmation e-mail will also include the application fees due and instructions on how to submit payment to CAU. At this time, online payments are not available. CAU must receive payment and all required documentation prior to processing the application.

To avoid duplicate applications, if you have already submitted a paper licensing application to CAU, please do not submit an application online. 

Overview of the Online Licensing/Certification Application Process
The online licensing application process is available at:
https://eforms.cdph.ca.gov
 

For forms and additional information on licensing/certification applications, please visit CAUā€™s website.

If you have any questions about this AFL, please contact CAU by phone at (916) 552-8632 or by email at CAU@cdph.ca.gov

 

Sincerely,

Original signed by Jean Iacino

Jean Iacino
Deputy Director

Attachment:
L&C Application User Guide for Providers

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