Home Care Organization Application Process
To apply for a license to operate a HCO, please complete the following steps:
- Review the HCS 281 for application instructions.
- Click on the links in the Section A chart below to access the appropriate application forms.
- Complete the application forms and compile all the supplemental documents listed in the Section B chart.
- Mail the completed application with appropriate application fees to the HCSB at:
California Department of Social Services
Home Care Services Bureau
744 P Street, M.S. T8-3-90
Sacramento, CA 95814
SECTION A: Home Care Organization Application Forms
|Section||Form Number||Form Title|
|A1||HCS 200||Application for a Home Care Organization License|
|A2||HCS 215||Licensee Applicant Information|
|A3||HCS 308||Designation of Home Care Organization Responsibility|
|A4||HCS 309||Partnership/Corporation/Limited Liability Company Organization Structure|
|A5||HCS 402||Employee Dishonesty Bond|
|A6||LIC 508||Criminal Record Statement|
|A7||HCS 9165||Board of Directors Statement|
SECTION B: Home Care Organization Application Supplement Documents
|Section||Title of Supplemental Document|
|B1||Partnership Agreement/Articles of Incorporation/Articles of Organization|
|B2||Job Description(s) - Each Position|
|B5||Home Care Organization Program Description|
After you submit your application, you will receive a notice stating that your application has been received. This notice will also provide you with information regarding:
- Your HCO number which you should use in all future communication;
- How to commence with the fingerprinting process; and
- How to complete the online orientation.