Requirements for Adding an Additional Home Care Site

This process will only apply if you have a licensed agency.

Procedure:

  1. Submit a completed licensure application (PDF, 56 KB) signed and dated with the $510.00 licensure fee.
  2. Submit a letter stating that you are adopting policies and procedures from your existing licensed site. Identify the name, address and license number of the existing licensed home care agency.
  3. Submit a copy of the Articles of Incorporation or Limited Liability Company (if applicable)
  4. Submit copy of the lease for the premise of the new site.
  5. Submit Agency Director resume and credentials. See 10A NCAC 13J.1001 (b) for qualifications for the Agency Director.

All of the above items must be submitted in their entirety for review.