Outpatient Physical Therapy/Speech-Language Pathology Provider āā
Application Instructions to Add an Extension Site
To receive a health facility certification in California, an applicant must fully complete the required application forms and submit them with all of the identified supporting documents. The Centralized Applications Branch (CAB) will not process incomplete applications.
These instructions assist in preparing an OPT/SP Extension Site application packet.
Please read each required application form carefully and:
- Provide all requested supporting documents
- Retain a copy of the completed application forms and supporting documents ā CAB may contact the applicant and will refer to the information provided
Review Process
CAB receives an application packet and assigns an application ID number in the Electronic Licensing Management System. A CAB analyst conducts a preliminary review of the application packet to validate receipt of all required forms and supporting documents.
Application packets missing forms and/or supporting documents are incomplete. CAB will only process complete applications.
Once validation is complete, a CAB analyst conducts a more extensive review to ensure compliance with state and federal requirements.
The CAB analyst completes the review process and approves the application packet, then sends the application packet to the district office to conduct all required surveys.
Submission of Applications
Submit completed application packets to:
California Department of Public Health
Licensing and Certification Program
Centralized Applications Branch
P.O. Box 997377, MS 3207
Sacramento, CA 95899-7377
If you have any questions, please contact CAB at (916) 552-8632 or by e-mail at
CAB@cdph.ca.gov.
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