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 Branch
744 P Street, M.S. 9-14-90
Sacramento, CA 95814
Section A: Home Care Organization Application Forms
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Section
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Form Number
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Description
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A1
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HCS 200
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Application for a Home Care Organization License
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A2
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HCS 215
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Licensee Applicant Information
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A3
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HCS 308
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Designation of Home Care Organization Responsibility
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A4
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HCS 309
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Partnership/Corporation/Limited Liability Company
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A5
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HCS 402
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Employee Dishonesty Bond
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A7
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HCS 9165
|
Board of Directors Statement
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Section B: Supplemental Documents
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Section
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Description
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B1
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Partnership Agreement/Articles of Incorporation/Articles of Organization
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B2
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Job Descriptions- Each Position
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B3
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Personnel Policies
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B4
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Training Plan
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B5
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Home Care Organization Program Description
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B6
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Insurance Information
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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.