Application for a Human Services License

The application below is for licensure of the following human service programs: Adult Training Facilities (55 Pa.Code Chapter 2380), Vocational Facilities (55 Pa.Code Chapter 2390), Personal Care Homes (55 Pa.Code Chapter 2600), Assisted Living Residences (55 Pa.Code Chapter 2800), Child Residential and Day Treatment Facilities (55 Pa.Code Chapter 3800), Community Residential Rehabilitation Services for the Mentally Ill (55 Pa.Code Chapter 5310), Long-Term Structured Residences (55 Pa.Code Chapter 5320), Community Homes for Individuals with Mental Retardation (55 Pa.Code Chapter 6400), and Family Living Homes (55 Pa.Code Chapter 6500). For Child Care Centers, please contact OCDEL.

Application for Certificate of Compliance (PW 633) (PDF download)

Initial Application Checklist for a Certificate of Compliance for Human Service Settings (PDF download)

Civil Rights Compliance Questionnaire Central Northern Region HS 2029 (PDF download)

Civil Rights Compliance Questionnaire Southeastern Region HS 2029.2 (PDF download)

Civil Rights Compliance Questionnaire Western Region HS 2029.1 (PDF download)

Bureau of Equal Opportunity (BEO) Regional Office Contact Information (PDF download)

 

Other Helpful Items:

New Home / Sale or Change of Legal Entity Policy

Human Services License Law (PDF download)

Chapter 20 Regulations (Applicable for all Licensed Facilities in Pennsylvania) (PDF download)

Frequently Asked Questions About Human Services Licensing Applications and Process (PDF download)