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Approval and Notification Information

The Health Facilities Program Section (HFPS) Application is used for processing transactions involving the operations of Intermediate Care Facilities (ICF) for the Developmentally Disabled (ICF/DD), Habilitative (ICF/DD-H), Nursing (ICF/DD-N) and Continuous Nursing (ICF/DD-CN) Programs.

DDS uses the updated Health Facilities Program Application Form (DS 1852) as a control document for the initial program plan review, Qualified Mental Retardation Professional (QMRP) approvals and notification of changes to your approved program plan.

Approvals:

For an initial Program Plan approval, you will receive an approval letter and a signed copy of the DS 1852. Any QMRP changes made after the initial program plan approval need to be reviewed and approved by the HFPS staff. Submit a copy of the QMRP applicant's degree, license or qualifying document and a copy of their resume along with the application completed front and back.

You will receive a decision on the requested action via a signed copy of the
DS 1852.  If the assigned analyst has any questions you will be contacted by phone, email or fax.

Notifications:

The California Code of Regulations, Title 22 Section 73859 and Section 76857 states:

"Any changes in the facility operation which alter the contents of the approved program plan, including changes of approved staff, shall be reported to the Department of Developmental Services within 10 working days."

Notifications of any changes to the program plan by a provider (other than the QMRP approval outlined above) should be provided to the Department in writing via mail or fax. The department does not provide letters of approval for these changes. If the Department has questions about your changes, the assigned analyst will contact you by phone, email or fax.

For changes to the facility ID Team Consultant staff other than the QMRP, it is the responsibility of the facility to obtain and maintain the current license or other qualifying document, resume and contract. The DS 1852 is not required for staff changes.

DDS keeps a database of all ICF/DD type facilities. We request your assistance to ensure that we have up to date information on file. Please use the DS 1852 to keep DDS updated with changes in addresses, email and phone numbers.

With your request for approval or notification of change, please submit any supportive documents with the DS 1852 indicating the type of change to:

The application, along with the supportive documents, will facilitate and expedite the processing of your request/notification while providing an official record of your transaction. If you have any questions regarding this process, contact the Health Facilities Program Section at (916) 654-1965 or send an e-mail to ddshfps@dds.ca.gov.