Adult Day Care Center Licensure
 

The Heath Facility Systems staff receives and processes applications for Adult Day Care Center licenses, renewals and amendments.  

---

Law and Rules
License Application and Attachments
Legal Resident Affidavit Forms
Contact Information

---

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.

---

Law and Unofficial Rules

Adult Day Care Act, 63 O.S. §§ 1-870 et seq. (15K)

Adult Day Care Center Rules, OAC 310:605 (259K)

    [Return to top of page.] 

---

License Application and Attachments

The following documents make up the License Application and attachments.

Adult Day Care License Application, ODH Form 712 (77K)

Adult Day Care License Application, 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)

Adult Day Care Renewal Application Checklist (25K)

    [Return to top of page.] 

---

Legal Resident Affidavit Forms

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)

    [Return to top of page.] 

---

Contact Information
Health Facility Systems
1000 NE 10th Street, Room 1010
Oklahoma City, OK  73117-1299
Phone 405.271.6868
Fax 405.271.7360
E-mail HealthResources@health.ok.gov

    [Return to top of page.]