Effective October 28, 2021, Adult Family Home applications received with a revision date other than September 2021 (REV. 09/2021) in the bottom left hand corner will be rejected.

Prospective applicants must attend the department-sponsored AFH orientation if they have not had an AFH license within the past 12 months. If you have already attended orientation but have not obtained an adult family home license within one calendar year of submitting the application to the department you must attend orientation again. Register for orientation (WAC 1-888-410-0943 )

Note: All application materials are in Word format.

How Long Does It Take To Become Licensed?

  • Processing of an application for licensure does not begin until the application is considered complete (i.e. all requested items received by the Business Analysis & Applications Unit);
  • Once the application is determined to be complete, the processing timeline begins and could take up to 60 days. 
  • On-site inspection by the Department must occur as part of the licensing process and licensure depends on the results of this inspection.
  • The majority of applicants do not meet minimum licensing requirements on the first inspection, thus requiring a subsequent visit.
  • After each inspection, the Department sends a letter to the applicant clearly outlining which licensing requirements have not been met and the specific issues that led to them not being met.
  • The Department has a maximum of 3 inspection visits; if after the third visit the applicant has still not met all the licensing requirements, the case is reviewed to determine the extent of the non-compliance and if a fourth visit is warranted.

The following are needed prior to applying for a license and/or contract:

Federal Employer Identification Number (EIN) - A copy of the IRS SS-4 form showing the assigned EIN number will be accepted as verification an EIN was obtained. For more information on EINs, visit https://www.irs.gov/

Unified Business Identifier (UBI) - A copy of the Washington State business license showing that the trade name has been registered with the Department of Revenue. For more information on UBIs, visit https://dor.wa.gov/open-business/apply-business-license

Certificate of Incorporation or Certificate of Formation issued by the Secretary of State. For more information on this registration, visit https://www.sos.wa.gov/corps/

APPLICATION PACKETS

Effective immediately, the street address for submissions to be delivered via Federal Express or United Parcel Service is:

Nursing Home Facility License Application (DSHS 10-670)

Effective June 21, 2021, NH applications received without a date of 05/2021 in the bottom left hand corner will be rejected.

Office for Civil Rights (OCR)

Related Materials

Download the following individual forms or informational handouts by clicking on the corresponding link:

If you are unable to view these documents online or require materials in hard copy format, please contact the Residential Care Services Business Analysis and Applications Unit at 1-888-410-0943.

If you have difficulty printing these documents, please read the Print Troubleshooting Guide.

How to become a licensed and contracted ESF Provider

If you are interested in becoming a licensed ESF, Residential Care Services (RCS) and HCS will meet with you to outline the process and provide ongoing assistance as you develop your plan for licensing. Request an information meeting by contacting HCS Residential Support Program Manager Sandy Spiegelberg, 1-888-410-0943 or sandra.spiegelberg@dshs.wa.gov

Once you are ready to apply for a license and/or contract:

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