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