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Adult Day Care Center Licensure
 


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
Contact Information


Note: Licensure Records of Long Term Care facilities have been scanned.  To receive a copy of a record email healthresources@health.ok.gov, with the following information:  Full name of facility; address and license number if known (i.e. 1005 SW OKC, NH5502); documents and dates of records records (i.e. all license applications and correspondence for 2005-2015).  Requests or inquiries for records can be faxed to 405-271-7360, or inquired about at 405-271-6868.

 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.


Provider Letters

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.


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)

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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 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)

Adult Day Care Renewal Application Checklist (25K)

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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)

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Contact Information

MAILING ADDRESS:
Health Facility Systems
P.O. Box 268823
Oklahoma City, OK 73126
LOCATION/WALKINS:
Oklahoma State Department of Health
Health Facility Systems
1000 NE 10th Street
Oklahoma City, OK  73117-1299

Phone 405.271.6868
Fax 405.271.7360 E-mail: Click here to email

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Frequently Asked Questions
Q: Where can I view records for licensure of long term care facilities?
A: : Licensure Records of Long Term Care facilities have been scanned. To receive a copy of a record email healthresources@health.ok.gov, with the following information: Full name of facility; address and license number if known (i.e. 1005 SW OKC, NH5502); documents and dates of records records (i.e. all license applications and correspondence for 2005-20015). Requests or inquiries for records can be faxed to 405-271-7360, or inquired about at 405-271-6868.

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