Application for a Human Services License

The Application for Certificate of Compliance (HS 633) is used to apply for a license of the following human service programs:
Children, Youth and Families Facilities: Adoption Services, County Children and Youth Agency, Day Treatment Program, Foster Family Care Agency Services, Group Day Care Home, Mobile Programs, Non-Secure Residential Services, Outdoor Program, Private Children and Youth Agency, Residential Child Care Facility, Secure Care Program, Secure Detention Facilities, Secure Residential Services, Supervised Independent Living Program, Transitional Living Program.
Mental Health Facilities: Community Residential Rehabilitation Service, Crisis Intervention Programs, Family Based Services, Long-Term Structured Residence, Partial Hospitalization , Private Psychiatric Hospital, Psychiatric Outpatient Clinic, Psychiatric Rehabilitation Facility, Residential Treatment Facilities Adults.
Personal Care Home and Assisted Living Residences

For Child Care Centers, please contact OCDEL.

For Intellectual Disabilities programs, please contact ODP.

 

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)