Intermediate Care Facility (ICF)
Change of Administrator Application Packet
A State license is required to operate as an Intermediate Care Facility (ICF) in California. An ICF is "a health facility that provides inpatient care to ambulatory or nonambulatory patients who have recurring need for skilled nursing supervision and need supportive care, but who do not require availability of continuous skilled nursing care," pursuant to Health and Safety Code section 1250(d). An ICF also means "a health facility, or a distinct part of a hospital or skilled nursing facility, which provides the following basic services: Inpatient care to patients who have need for skilled nursing supervision and need supportive care, but who do not require continuous nursing care", pursuant to Title 22 of the California Code of Regulations (CCR) section 73051.
To report a Change of Administrator, you must complete the required application packet. Refer to 22 CCR sections 73001 through 73727 for information regarding licensure requirements.
How to Apply
An applicant must submit a completed application packet to the Centralized Applications Branch (CAB). The application packet contains the required forms in one location. The provider checklist identifies the required forms and supporting documents needed to apply for licensing and certification. The provider instructions are a resource to guide you through the process. The Sample Application Packet is a visual aid that displays a sample of the completed forms contained in the application packet.
Please refer to the following links to get started:
Where to Submit Applications
Submit completed application packets to the CAB at the address listed below. Do not send any completed application packets, forms, or supporting documents to the local CDPH, District Office.
California Department of Public Health
Licensing and Certification Program
Centralized Applications Branch
P.O. Box 997377, MS 3207
Sacramento, CA 95899-7377