||Contact | A-Z Health Index | Events & Meetings|
The Heath Facility Systems staff receives and processes applications for Adult Day Care Center licenses, renewals and amendments.
Note: The files on this page have been converted to PDF files. You will need the Adobe™ Acrobat ™ Reader to view the files. A short-cut is provided on the left in the blue column.
HRDS-HFS2012-01 Change in License Renewal Date (June 14, 2012)
Adult Day Care Act, 63 O.S. §§ 1-870 et seq. (15K)
Adult Day Care Center Rules, OAC 310:605 (259K)
The following documents make up the License Application and attachments.
Adult Day Care License Application, ODH Form 712 (77K)
Adult Day Care License Application Fill-In, ODH Form 712 (77K)
Disclosure Statement of Owner, Lessee and Manager for a Long-Term Care Facility, ODH Form 953- B (1M)
Detail Attachment to the Disclosure Statement, ODH Form 953-C (84K)
Affirmation Attachment to the Disclosure Statement, ODH Form 953-D (72K)
Staffing Projection and Professional Certification for a Nursing or Long-Term Care Facility, ODH Form 953-E (84K)
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 (29K)
Affidavit of Lawful Presence by Guardian of Person Making Application for a License, Permit or Certification, ODH Form 266 (32K)
Copyright © State of Oklahoma