The California Department of Public Health (CDPH) has updated the Licensure and Certification Application (HS 200) and Applicant Individual Information (HS 215A) forms, effective July 1, 2023. The revisions aim to capture additional licensing/certification requirements, improve clarity, and facilitate accurate form completion. Major updates include additional application types, facility types, managing positions, and facility information. The revised HS 200 form also includes Medi-Cal disclosures previously collected on the DHCS 6207. The revised forms must be used for applications submitted from January 1, 2024. Facilities should continue using the HS 200 and HS 215A forms dated 02/08 until December 31, 2023.

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