Pediatric Day Health and Respite Care (PDHRC) Facility
Change of Name Application Packet
A State license is required to operate as a Pediatric Day Health and Respite Care (PDHRC) Facility in California. A PDHRC facility means a facility that provides an organized program of therapeutic social and day health activities and services and limited 24-hour inpatient respite care to medically fragile children 21 years of age or younger, including terminally ill and technology-dependent patients (except for individuals who are 22 years of age or older may continue to receive care in a PDHRC facility if the facility receives approval from the state department for a functional unit of a PDHRC facility that is organized, staffed, and equipped to provide care to individuals who are 22 years of age or older) pursuant to Health and Safety Code (HSC), section 1760.2(a)(1).
To report a Change of Name, you must complete the required application packet. Refer to HSC section 1760.4 and HSC section 1267.13 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