Skip Navigation LinksGACH-APH-License-Suspension-Provider-Checklist

Top Menu
Left Menu

HEALTH CARE FACILITY LICENSING AND CERTIFICATIONā€‹ā€‹ā€‹

Contact Us

Phone: (916) 552-8632
Email: CAB@cdph.ca.gov     

For application status requests, please include the following in your email:

  • Name of Facility or Agency
  • License or Facility/Agency # (if applicable)
  • Address
  • Facility or Provider Type
  • Date Documentation Sent
  • Contact Numberā€‹ā€‹ā€‹ā€‹ā€‹ā€‹

General Acute Care Hospitals and Acute Psychiatric Hospitals

License Suspension

Required Documents

Online Application PDF Form
  • Embedded and generated by online system
License Suspension
  • Proof that the facility notified the California Department of Public Health (District Office) 180 days prior to the planned reduction or elimination of the level of emergency medical services, the notification of the intended change*
  • Copy of the notice to the city council of the city in which the facility is located*
  • Copy of the notice that was provided to the California Department of Public Health (District Office) *
  • Proof of a notice posted in a conspicuous location on the home page of the facility's internet website*
  • Proof of a notice published in a conspicuous location within a newspaper of general circulation serving the local geographical area in which the facility is located*
  • Proof of a notice in a conspicuous location within the internet website of a newspaper of general circulation serving the local geographical area in which the facility is located*
  • Proof of a notice posted at the entrance of every community clinic, within the affected county in which the facility is located, that grants voluntary permission for postingā€‹

*Note: These reporting conditions do not apply to a facility forced to close or eliminate service as a result of a natural disaster or state of emergency that prevents the facility from operating at its full pre-emergency capacity. (All Facilities Letter (AFL) 21-04)ā€‹

Page Last Updated :