Georgia personal care home permit: from two residents to 25 beds and beyond

Two unrelated adults trigger the permit

Chapter 111-8-62 defines a personal care home as “any dwelling, whether operated for profit or not, which undertakes through its ownership or management to provide or arrange for the provision of housing, food service, and one or more personal services for two or more adults who are not related to the owner or administrator by blood or marriage.”⁠¹ Take each part of that test in turn:

• “Provide or arrange.” You need the permit even if you do not provide the care yourself, as long as you arrange for it.⁠¹
• One personal service is enough. Personal services include help with or supervision of self-administered medication, help with walking and transfers, and help with eating, bathing, grooming, dressing and toileting.⁠¹ Room and board plus medication reminders for two unrelated adults is a personal care home.
• Relatives do not count. A resident who is related to the manager or a governing body member by blood within the third degree, or by marriage, is not a “non-family adult.”⁠¹

The rule calls the authorization itself a “permit,” which DCH grants to the governing body. Without a current permit, no home may operate and no resident may be admitted.⁠¹ The permit belongs to one address and one owner. It becomes void when the home moves, the ownership changes or the governing body changes significantly. Each home on separate premises needs its own permit, even under one owner.⁠¹

Who is exempt

Section 111-8-62-.04 lists the arrangements that fall outside the rules:⁠¹

• boarding homes or rooming houses that give lodging and meals and no personal services;
• temporary emergency shelters, such as homeless and family violence shelters;
• facilities regulated by the Department of Behavioral Health and Developmental Disabilities (DBHDD);
• group residences set up by or for people who live independently or manage their own care and share the cost of attendants, rent, utilities and food;
• charitable organizations that provide shelter and services without charging residents any fee;
• community living arrangements under Chapter 290-9-37;
• medical foster homes regulated by the U.S. Department of Veterans Affairs;
• correctional residential facilities, and other facility types DCH licenses under their own rules, such as assisted living communities and hospices.

The community living arrangement (CLA) exemption matters if you plan to serve adults with developmental disabilities or mental illness. A CLA is a home whose residential services are paid for wholly or partly by DBHDD funds. DCH regulates CLAs through the same Personal Care Home Program, under Chapter 290-9-37.⁠³ A CLA cannot operate on the same premises as a personal care home.⁠¹

Operating without a permit is costly. If DCH investigates an unlicensed-home complaint, the application you are then required to file carries a $550 involuntary application processing fee, instead of $300.⁠⁵ DCH can also seek a court injunction against a facility running without a license, and it may refuse an initial license without first holding a hearing.⁠⁴

Personal care home, assisted living community or memory care center

DCH’s Personal Care Home Program oversees three closely related authorizations, and choosing the wrong one costs time.

An assisted living community is, in DCH’s words, “a personal care home serving 25 residents or more that is licensed by the department to provide assisted living care.”⁠³ Assisted living care adds medication administration by certified medication aides, help with self-preservation in an emergency, and limited nursing services.⁠¹ A personal care home that does not hold the assisted living permit may not provide assisted living care. It also may not use the term “assisted living” in its name or marketing materials.⁠¹ So a 30-bed home can be either one: a personal care home if residents are ambulatory and only need help with self-administered medications, or an assisted living community if you want to serve residents who need more. DCH’s packet has a separate track for converting a personal care home of at least 25 beds to an assisted living community.⁠² Our Georgia assisted living community permit guide covers that permit.

A memory care center is not a separate facility type. It is a certificate added to a personal care home or assisted living community permit. You need it if you hold yourself out as giving specialized care to residents with probable Alzheimer’s disease or other dementia, or if you charge those residents more than others.⁠¹ DCH’s checklist says you must already hold a personal care home permit before you apply. The application is a notarized identity affidavit, a copy of the photo ID and a notarized affidavit of compliance.⁠² The certificate carries its own $200 annual fee.⁠⁴ The rule’s requirements are heavy for a small home:⁠¹

• one dementia-trained direct care staff person for every 12 residents during waking hours and every 15 overnight, as a monthly average;
• at least two direct care staff on site at all times;
• a registered nurse, LPN or certified medication aide on site or in the building at all times;
• RN or LPN hours of at least 8 a week for 1 to 12 residents, rising to 16, 24 and 40 hours a week as the center grows;
• four hours of dementia orientation for all staff within 30 days, 16 hours of competency-based training for direct care staff, and 8 hours a year after that (requirements in effect since July 1, 2021);
• secured outdoor space, an automated alert on unattended exits, and a written description of the center that you give families before admission.

A home that serves residents at risk of wandering but does not market dementia care still has duties. It needs elopement policies, safety devices that meet fire rules, and current photos of those residents on file.⁠¹

The 25-bed line

Georgia does not have a separate license for small homes. It has one permit with a dividing line at 25 beds. Decide your bed count before you buy or lease, because crossing the line changes your administrator, staffing, paperwork and fees.

Sources: ⁠¹⁠²⁠⁴⁠⁶

Some details sit behind the table:

• Administrator licensing. For a 25-plus-bed home, the administrator’s license must take effect within 60 days of hire, or by July 1, 2021, whichever is later.⁠¹
• The CPA affidavit. It must affirm that you can operate as a going concern for the next two years.⁠¹ DCH’s form lets a new applicant’s CPA rely on “forward-looking documents” such as a pro forma statement if no prior-year financials exist.⁠²
• Health planning. DCH’s checklist requires a letter of determination from the Office of Health Planning for every 25-plus-bed application.⁠² A full certificate of need is required only for “personal care homes with 25 or more beds that are Medicaid certified.”⁠⁶ CON applications require a letter of intent before the application itself.⁠⁶
• Floor staffing. A 25-plus-bed home must keep a staff member posted on each occupied floor. That person may move around the building only if the home runs a medical alert system and has offered every resident a wearable device that alerts staff.⁠¹
• Smaller rules. Homes licensed for more than 24 residents must also have staff wear visible ID badges.⁠¹

The more practical line for a house-sized home is 7 beds, the point at which DCH’s checklist requires a sprinkler system.⁠²

Fire safety, sprinklers and the floor sketch

Personal care homes must comply with the Safety Fire Commissioner’s rules.⁠¹ Under Chapter 120-3-3, a personal care home that is not an assisted living community or memory care unit must meet the Residential Board and Care chapters of NFPA 101, the Life Safety Code. The fire rules define residential board and care as lodging and personal care for four or more unrelated residents.⁠⁸ The application needs a fire safety inspection report from the appropriate fire safety authority. It must show no violations, state the capacity load and be dated within 12 months of submission. DCH requires a sprinkler system at 7 or more beds.⁠²

Fire training is a separate state requirement. The Safety Fire Commissioner’s rules require the administrator, directors, operators and all staff of personal care homes to take three hours of initial fire safety training within 90 days of licensure or hire, from an instructor registered with the Commissioner’s office. Everyone then needs a two-hour refresher every three years.⁠⁸

Chapter 111-8-62 adds its own building rules on top of the fire code:⁠¹

• Bedrooms. At least 80 square feet of usable floor space per resident, counting only floor under a ceiling at least 7 feet high. No more than four residents per room. Each room needs a window in an exterior wall and floor-to-ceiling walls, and nobody may pass through one bedroom to reach another room. Homes approved at 70 square feet on or before February 6, 1981 and operating continuously since keep that standard only until the permit is revoked or surrendered, ownership changes, the home moves or it is extensively renovated.
• Below grade. No bedroom may sit more than half below ground level.
• Bathrooms. One toilet and sink for every four residents, one tub or shower for every eight, and a toilet and sink on each floor with resident bedrooms. Grab bars and nonskid surfaces are required in every bath and shower.
• Common space. Living, dining and bedroom areas must be separate. No living room, dining room or hallway may be used for sleeping by anyone, including staff, family or renters.
• Fire equipment. Smoke detectors wired to house power with battery backup that sound in the bedrooms. At least one charged 5-lb ABC extinguisher on each occupied floor and in the basement, checked yearly. No space heaters except in an emergency with written approval from the fire authority.
• Electrical inspection. A licensed electrician or local code official must inspect the electrical service and find it free of hazards no more than six months before you file.
• Hot water and street signage. Water at the tap no hotter than 120°F, and the house number and home name visible from the street.
• Exits. Residents who need help walking must have bedrooms with a ground-level exit or an accessible ramp or elevator. Each bedroom needs a secondary exit, which may be a usable window. A home serving wheelchair or scooter users needs two accessible exits remote from each other.
• Beds. Each resident needs a bed at least 36 by 72 inches. Cots, bunks, roll-aways and sofa beds may not replace standard beds.

The floor sketch you submit becomes the reference DCH holds you to. Any later change that alters it needs DCH approval first.⁠¹ Local zoning is your job. The rule says zoning and other local requirements “must be addressed by the applicant with the responsible local officials,” and DCH’s checklist asks for documented city or county zoning approval.⁠¹⁠²

The administrator, owners and background checks

Every home needs an administrator who is at least 21 and meets the education rules in the table above.⁠¹ Name the administrator or on-site manager in the application if you can. If not, DCH must have the name before it issues the permit.⁠¹ The on-site manager and any direct care supervisor must also be 21. Hands-on staff who do not supervise must be at least 18.⁠¹

Georgia uses fingerprint-based checks run through DCH’s Georgia Criminal History Check System (GCHEXS). The checks cover state and federal records.⁠⁷ The rule requires a check:⁠¹

• for the owner, before any new license is issued;
• for directors, administrators and on-site managers, before they are hired;
• for every direct access employee, before that person starts in the role.

DCH’s checklist asks for a satisfactory GCHEXS determination letter dated within 12 months of the application. The letter must cover all administrators and every individual owner with 10% or more of the business. If nobody holds 10%, you submit a signed letter on company letterhead saying so.⁠² To get access, the owner or administrator registers a facility account in GCHEXS.⁠⁷ The application must also disclose corporate officers, everyone owning 10% or more, and the registered agent.⁠¹ Each applicant also signs a notarized affidavit of citizenship or lawful presence under O.C.G.A. § 50-36-1.⁠²

Staffing and training at every size

The base ratio is the same for every home: one awake direct care staff person for every 15 residents during waking hours. Overnight, the rule requires one awake staff person per 25 residents in homes under 25 beds, and one per 20 in larger homes.⁠¹ Three points matter more than the numbers:

• Someone on site at all times. At least one administrator, on-site manager or responsible staff person must be on the premises 24 hours a day, with one staff person per occupied floor.⁠¹ A two-story, six-bed home with residents sleeping upstairs and downstairs needs a staff person on each floor overnight, so two people, even though the ratio alone would allow one.
• Who counts. Cooks, maintenance workers, hospice staff, home care agency aides and private sitters do not count toward the ratio. Residents never count as staff.⁠¹
• Ratios are a floor. All homes must staff above the minimums when residents’ needs require it, and keep written staffing plans and monthly schedules showing planned and actual coverage. Completed schedules must be kept for a year.⁠¹

Every worker needs training within the first 60 days covering first aid, CPR with return demonstration, evacuation, the residents’ needs, abuse and neglect reporting, and infection control. At least one fully trained staff person must be in the home whenever any resident is there.⁠¹ Direct care staff, the administrator included, need 16 hours of continuing education a year.⁠¹ Before employment, each staff member needs a TB screening and a physical exam done within the previous 12 months. You must also verify a five-year employment history where possible.⁠¹

Who you can admit and keep

Georgia’s personal care home model is built around residents who can get out in a fire. Residents must be at least 18. Apart from aging-in-place exceptions, a home may admit and keep only ambulatory residents who can save themselves with minimal help, meaning staff may help them out of a chair or bed and give verbal directions.⁠¹ A home may let up to three residents who have become non-ambulatory stay as an “aging in place” exception. While any such resident lives there, the home must:⁠¹

• prove it can evacuate everyone in 13 minutes or less;
• run a fire drill every month across all shifts;
• notify the local fire department in writing within two weeks;
• staff every shift for a safe evacuation.

DCH can revoke the exception during a survey.⁠¹

A home may not admit anyone who needs continuous medical or nursing care, or anyone who needs restraints, isolation or confinement to manage behavior. Nursing and therapy needed periodically or for a short illness must come from independently managed licensed providers, such as a home health agency or hospice, that the resident pays for. The home may help arrange that care but may not provide it.⁠¹ Before admission you need a physical exam report dated within 30 days, on DCH’s own form. Emergency placements by adult protective services, police or a case manager get 14 days to supply one.⁠¹

The written admission agreement has required contents. These include 30 days’ written notice before raising personal service charges and 60 days before raising room and board. It must also state who handles medications and whether residents may hire their own sitters. For residents admitted after July 1, 2025, a home that uses a medical alert system must describe it and state that using it is optional.⁠¹

Medications

Outside a memory care center, the home’s unlicensed staff assist with self-administered medications; they do not administer them. Trained unlicensed staff may bring a resident’s labeled medication and open it. They may place a dose in the resident’s hand, apply topical medications, help with drops, inhalers and patches, and help with an EpiPen under a written protocol that includes calling 911.⁠¹ Those staff must be proficient in English. The home must give them documented training on a curriculum covering at least nine set topics and check their skills when hired and every year.⁠¹ Every medication, including over-the-counter products, needs a prescriber’s order or an individual prescription bottle on file. New prescriptions must be obtained within 48 hours. A daily medication assistance record is required for every resident who gets help.⁠¹

In a certified memory care center, medications must be given by an RN, an LPN under supervision, a trained proxy caregiver or a certified medication aide. Using medication aides brings quarterly nurse or pharmacist observations and quarterly pharmacist drug regimen reviews.⁠¹

Applying through GAHLES

DCH takes personal care home applications through its online portal, GAHLES (gahles.dch.georgia.gov). HFRD’s forms page posts the Personal Care Home Application Packet, last updated July 13, 2026, and links to interactive GAHLES training.⁠²⁠¹¹ DCH asks you not to submit until every document is ready. It will not act on an incomplete application, and failing to upload requested documents “will result in the denial of your application.”⁠¹⁠² Work in this order:

1. Set up the governing body

   The applicant is the sole proprietor, the general partners, or the LLC, association or corporation acting through its governing body.⁠¹ The packet asks for Secretary of State registration for an entity.⁠²

2. Secure the property and zoning

   You need a deed, lease, bill of sale or property record in the governing body’s name, plus documented city or county zoning approval.⁠²

3. Get the building inspected

   This means a fire safety inspection report showing capacity, dated within 12 months, with sprinklers if you will have 7 or more beds. You also need DCH’s Electrical Inspection Compliance Form signed by a Georgia-licensed electrician within 6 months.⁠² For public water and sewer, a water bill with sewage charges is enough. With a septic tank, the county environmentalist completes DCH’s Water and Septic Tank Report Form, stating the maximum residents the system supports. A private well needs a water test dated within 6 months.⁠²

4. Draw the floor sketch

   Label every room and give bedroom measurements, every door and window, and bed placement for residents, family and staff.⁠¹⁠²

5. Run background checks

   Get GCHEXS determination letters for the administrator and 10% owners.⁠²

6. For 25 or more beds,

   obtain the Office of Health Planning letter of determination and the notarized CPA affidavit of financial stability.⁠²

7. Complete the GAHLES application

   This includes the electronic owner form, the notarized identity affidavit and a copy of the photo ID shown to the notary. Then pay the fees.⁠²

8. Have your policies written

   The packet reminds applicants that all policies and procedures must exist and be available on request.⁠² The rule lists 16 required subjects, including admissions and discharges, refunds, medication management, abuse reporting, emergency preparedness and the staffing plan.⁠¹ Homes must also meet DCH’s disaster preparedness plan rules in Chapter 111-8-16.⁠¹

Status updates go to the contact email on your application; requests for more documents come from [email protected] with a link and a verification code to reopen the application.⁠² Rule questions go to the Personal Care Home team at [email protected]. Application questions go to [email protected]. The program’s phone number is 404-657-5700.⁠²⁠³ Neither the rules nor DCH’s pages give a processing time for initial permits.

Fees

Sources: ⁠⁴⁠⁵

The initial permit fee equals the annual fee for your bed count.⁠⁴ All fees must be paid before DCH issues the permit, and application fees are not refunded.⁠²⁠⁴ Annual fees fall due on the anniversary of the permit. DCH may revoke a permit if they go unpaid 60 days after an invoice.⁠⁴ DCH does not accept cash.⁠⁴

Once you are open

DCH’s surveyors carry out unannounced compliance inspections about every 11 to 15 months, along with complaint and follow-up visits. The Personal Care Home Program had 24 surveyors covering 2,910 facilities (personal care homes, assisted living communities, community living arrangements and adult day centers combined) when DCH last updated its page.⁠³ After a cited inspection, you have 10 days to file a plan of correction. You must post the latest report and plan in the home. If the home has a website, its main page must link to all reports and plans from the past 18 months.⁠¹ The public can look up permits and inspection reports on DCH’s GaMap2Care site.⁠³

Some reporting deadlines are short:⁠¹

• If a resident goes missing, staff must call local police within 30 minutes under the Mattie’s Call Act, and report the call to DCH within 30 minutes as well.
• Serious incidents, including unexpected deaths, injuries needing medical treatment, abuse and an employee’s new criminal record, go to DCH within 24 hours.
• Before any bankruptcy or eviction that could force residents out, you must give DCH and residents 60 days’ written notice.
• A sale needs 30 days’ notice and a new application approved before the buyer’s permit issues.

Fines under the general enforcement rules reach $2,000 per violation per day, capped at $40,000 for one inspection. A violation that causes a resident’s death or serious physical harm carries a mandatory fine of at least $5,000.⁠⁴ If a specific rule causes undue hardship, DCH can grant variances and waivers on its application form.⁠¹

Medicaid: Alternative Living Services

The Medicaid route into personal care homes runs through the Elderly and Disabled Waiver Program. Its CCSP and SOURCE programs serve frail elderly and disabled Georgians who meet the nursing facility level of care. Their services include “alternative living services.”⁠⁹ The Division of Aging Services describes alternative living services as “24-hour supervision, medically-related personal care, nursing supervision and health-related support services in state-licensed personal care home.”⁠¹⁰ The permit therefore comes first. If you plan a 25-plus-bed home and want Medicaid certification, add the certificate of need review described above to your timeline.⁠⁶

Related reading: the Georgia state overview, small residential care homes across states, and, if you also plan to send aides into private homes, the Georgia private home care provider license guide.

Sources

1. 1
   Georgia Secretary of State, Rules and Regulations of the State of Georgia, Ga. Comp. R. & Regs. ch. 111-8-62, Rules and Regulations for Personal Care Homes Checked 12 Oct 2026 · Back to text ↑
2. 2
   Georgia Department of Community Health, Healthcare Facility Regulation Division, Personal Care Home Application Checklist and Packet (updated 07/13/26) Checked 12 Oct 2026 · Back to text ↑
3. 3
   Georgia Department of Community Health, Healthcare Facility Regulation Division, Personal Care Homes Checked 12 Oct 2026 · Back to text ↑
4. 4
   Georgia Secretary of State, Rules and Regulations of the State of Georgia, Ga. Comp. R. & Regs. ch. 111-8-25, Rules and Regulations for General Licensing and Enforcement Requirements Checked 12 Oct 2026 · Back to text ↑
5. 5
   Georgia Department of Community Health, Healthcare Facility Regulation Division, Schedule of Licensure Activity Fees (October 2024) Checked 12 Oct 2026 · Back to text ↑
6. 6
   Georgia Department of Community Health, Office of Health Planning, Certificate of Need fact sheet (updated 2025) Checked 12 Oct 2026 · Back to text ↑
7. 7
   Georgia Department of Community Health, Office of Inspector General, Georgia Criminal History Check System (GCHEXS) Checked 12 Oct 2026 · Back to text ↑
8. 8
   Georgia Office of Insurance and Safety Fire Commissioner, Chapter 120-3-3, Rules and Regulations for the State Minimum Fire Safety Standards Checked 12 Oct 2026 · Back to text ↑
9. 9
   Georgia Medicaid, Department of Community Health, Long Term Services and Supports Checked 12 Oct 2026 · Back to text ↑
10. 10
    Georgia Department of Human Services, Division of Aging Services, Chapter 200: The Community Care Services Program (CCSP) Checked 12 Oct 2026 · Back to text ↑
11. 11
    Georgia Department of Community Health, Healthcare Facility Regulation Division, Licensure Forms & Applications Checked 12 Oct 2026 · Back to text ↑

Was this information accurate? Report an errorPrint or save as PDF