The Heath Facility Systems staff receives and processes applications for Adult Day Care Center licenses, renewals and amendments.
Inspection Reports Provider Letters Law and Rules License Application and Attachments Legal Resident Affidavit Forms Frequently Asked Questions Contact Information
HRDS-HFS2012-01 Change in License Renewal Date (June 14, 2012)
Letter Overview Oklahoma law was amended to allow for license renewal to occur throughout the year. For licenses expiring July 31, 2012, the license expiration dates will be distributed over a period of twelve (12) to twenty-four (24) months.
Adult Day Care Act, 63 O.S. §§ 1-870 et seq.
Adult Day Care Center Rules, OAC 310:605
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The following documents make up the License Application and attachments.
Adult Day Care License Application, ODH Form 712
Disclosure Statement of Owner, Lessee and Manager for a Long-Term Care Facility, ODH Form 953- B
Detail Attachment to the Disclosure Statement, ODH Form 953-C
Affirmation Attachment to the Disclosure Statement, ODH Form 953-D
Staffing Projection and Professional Certification for a Nursing or Long-Term Care Facility, ODH Form 953-E
Adult Day Care Renewal Application Checklist
Note: The applicable form below is required for an applicant applying for a license as an individual.
Affidavit of Lawful Presence by Person Making Application for a License, Permit or Certification, ODH Form 301
Affidavit of Lawful Presence by Guardian of Person Making Application for a License, Permit or Certification, ODH Form 266
Mailing Address: Oklahoma State Department of Health Health Facility Systems 123 Robert S. Kerr Ave., Suite 1702 Oklahoma City, OK 73102-6406
Physical Address: Oklahoma State Department of Health 123 Robert S. Kerr Ave. Oklahoma City, OK
Phone: (405) 426-8175 Fax: (405) 900-7571 E-mail: Click Here
