Ohio Class Two residential facility license: the behavioral health route for 3-16 adults

Why a care home for older adults is licensed by behavioral health

Ohio’s license for small adult care homes sits outside the Department of Health. A home that gives accommodations, supervision and personal care to three to sixteen unrelated adults is a Class Two residential facility, and the Ohio Department of Behavioral Health (DBH) inspects and licenses it ⁠¹. The residents do not need a mental illness diagnosis for the home to fall into this class; the age and need of the residents do not move the license to the Department of Health ⁠¹.

The statute also reaches very small homes. You need a Class Two license to serve even one or two unrelated people if they have a mental illness or receive payments under the Residential State Supplement (RSS) program ⁠¹. Older DBH documents call these homes “adult care facilities” and “adult foster homes”; the RSS procedure still uses those names for homes licensed for up to sixteen people ⁠¹².

DBH’s own page describes Class Two homes as a home-like setting for adults with mental illness, with up to 16 residents, that may or may not be staffed around the clock, that cannot provide mental health treatment on site, and that can serve as permanent housing ⁠³. That description reflects who lives in most of these homes. The legal test is in the statute, and the statute covers any three to sixteen unrelated adults ⁠¹.

DBH was called the Ohio Department of Mental Health and Addiction Services (OhioMHAS) until House Bill 96 renamed it. Every statute, rule or form that still says OhioMHAS now means DBH ⁠⁸. Most of the licensing rules in OAC Chapter 5122-30 still carry the old name, because they have been in effect since January 1, 2018 ⁠².

What counts as personal care and supervision

Ohio defines both terms broadly, so you can cross the line without meaning to:

• Personal care means helping with activities of daily living, helping residents self-administer medication, or preparing special diets (other than complex therapeutic diets) under a physician’s or dietitian’s instructions. Providing any one of these counts ⁠¹.
• Supervision includes watching a resident during daily activities, reminding a resident to bathe or take care of themselves, and helping a resident make or keep an appointment ⁠¹.
• Unrelated means the resident is not the owner’s or operator’s (or their spouse’s) parent, grandparent, child, stepchild, grandchild, sibling, niece, nephew, aunt, uncle or first cousin ⁠¹.

If you only rent rooms and serve meals, with no supervision or personal care, you are not a Class Two facility. A home that gives room and board to five or more adults with mental illness is a Class Three facility, and a home that adds mental health treatment is a Class One ⁠¹.

The licenses next door: Class One, Class Three and ODH residential care facilities

The statute also excludes hospice-only facilities, VA-approved homes used only for veterans, shelters funded by the Department of Development for homeless people, and the home of a relative or guardian of a person with mental illness ⁠¹.

For a larger assisted living building, or any home where your staff will give skilled nursing, read the Ohio residential care facility license guide. If you plan to send caregivers into clients’ own homes instead, see the nonmedical home health services license.

The skilled nursing limit decides whether this is the right license

A Class Two facility may not provide skilled nursing care, the term ORC 3721.01 uses for things like dressing changes, tube feedings, injected medication, and nursing assessment of a changing condition. DBH treats care as provided by the facility if it comes from anyone employed by or associated with the facility, including a home health company owned by or associated with the operator ⁠².

A resident who needs skilled nursing can still live in your home in one narrow case. The care must be part-time and intermittent: fewer than 8 hours in a 24-hour day, or fewer than 40 hours in a seven-day period, and no more than 120 days in any 12 months. It must come from a Medicare-certified home health agency, a licensed hospice, or a mental health or substance use treatment provider or board ⁠². When a resident’s health changes in a way that could call for a different type of facility, you must contact their physician or case manager within 24 hours ⁠².

Medication is a related limit. Class Two staff may not administer medication. They may remind residents, take medication out of locked storage and hand it over, open containers, and help a physically impaired but mentally alert resident take oral or topical medication ⁠¹. When staff help with prescription medication, a staff member must be present and stay on duty at least one hour afterward ⁠².

Zoning, the house and the inspections you collect first

DBH’s toolkit tells new operators to get zoning clearance and a certificate of use from the local building and zoning office before applying ⁠⁴. State law limits what local zoning can do:

• A Class Two home for one to five residents is a permitted use in any residential district, including single-family zones. The city can apply only the area, height, yard and architectural rules it applies to every single-family home in that zone ⁠⁵.
• A home for six to sixteen residents is a permitted use in multiple-family districts. A city or township can make it a conditional use or special exception there, can impose design, yard, parking and sign rules, and can exclude it from planned-unit developments ⁠⁵.
• A local government with zoning may limit “excessive concentration” of Class Two homes, although homes that were operating on September 10, 2012 are protected ⁠⁵.

You also need proof that you own the house, or a signed agreement from your landlord allowing its use as a residential facility ⁠².

Inspections that go into the application

OAC 5122-30-11 sets out which inspections you obtain and pay for yourself ⁠²:

• Fire inspection by a certified fire authority, the State Fire Marshal or an approved local fire department, repeated within every 12 months.
• Well and septic inspection by the local health department, if the house is not on public water and sewer.
• Five or fewer household members: an electrical inspection by a licensed electrical inspector, plus a heating and cooling inspection by a licensed heating contractor.
• Six or more household members: a building inspection or certificate of occupancy for the correct use group under the Ohio building code. This replaces the electrical and heating inspections.
• A food service license only if local law requires one, plus elevator or boiler inspections where they apply.

“Household members” counts everyone who lives in the house, including you, your family and live-in staff, not only residents ⁠². That figure, not the resident count alone, decides which inspection path and how many bathrooms you need.

Physical requirements DBH checks on site

Class Two homes must also keep at least one refrigerator unlocked, with drinks and snacks for residents, and give residents unrestricted use of a telephone that is not just a cell phone. Laundry must be provided at no extra charge ⁠². Residents share bedrooms only with other residents, and you must furnish their rooms comparably to the bedrooms of other household members ⁠².

Fire safety thresholds

The fire rules in OAC 5122-30-12 step up with the residents you accept ⁠²:

• Every home needs fire extinguishers on each floor near bedrooms, smoke and carbon monoxide detectors under the state building and fire codes, posted evacuation drawings on each floor, a written disaster plan, and evacuation drills at least quarterly on each shift.
• With nine or more ambulatory residents, you need a combined smoke detector and fire alarm system with interconnected detectors and two independent exits from each occupied floor.
• With even one non-ambulatory resident, meaning someone who cannot get in and out of bed alone, cannot walk without another person’s help, or uses a wheelchair, you need smoke detectors, a fire alarm, an automatic fire extinguishing system, two exits per floor, and annual alarm and sprinkler testing ⁠².

That sprinkler requirement often decides whether a house can serve residents who use wheelchairs. Firearms and other weapons are banned from the premises, and residents may never be locked in a room or locked out of the house ⁠².

Who can own, manage and work in the home

The operator is the person or entity responsible for running the facility and is the applicant and licensee. The operator, manager and owner can be the same person ⁠². The operator must keep enough money on hand to run the home safely, keep utilities out of residents’ names, and tell DBH within one business day if any utility bill is 30 days past due or a shutoff notice arrives ⁠².

Background checks before the license, not after

OAC 5122-30-31 applies the same checks to owners, operators, managers, employees and non-resident occupants ⁠²:

1. BCI check with FBI results

   Ask the Ohio Bureau of Criminal Investigation for a criminal records check that includes FBI information.

2. Database checks

   Search the HHS-OIG exclusion list, the Ohio developmental disabilities abuser registry, the nurse aide registry, the federal SAM database, the U.S. Department of Justice national sex offender public website (nsopw.gov), and the state prison offender database. Print the results and keep them in the file.

3. Signed statements

   The applicant attests they have no disqualifying offense and agrees to report any new charge within 14 days.

4. Repeat

   the checks at least every four years.

Disqualifying offenses fall into five tiers, from permanent exclusion down to shorter waiting periods ⁠². DBH will not approve an operator conditionally while results are pending ⁠². Separately, the application must disclose any adverse action another regulator took in the past three years against the facility, any owner, operator or manager, or, since House Bill 96, any subsidiary. Once you are licensed, you must report a new adverse action within seven days ⁠⁶⁠⁸. If a license you held was revoked or not renewed, you must wait at least 24 months before applying again. If the revocation involved abuse, neglect or exploitation, the 24-month exception does not apply ⁠².

Training and staffing

Every staff member must be at least 18 and must test negative for tuberculosis within the year before starting work ⁠². Direct care staff need training within 30 days of hire, and must work alongside trained staff until they finish ⁠². The training covers:

• In-person first aid and CPR (online courses are not accepted);
• fire and disaster procedures and getting emergency help;
• resident rights and grievance procedures;
• Ohio’s abuse and neglect reporting law.

Staff who help with medication also need training from a registered nurse, physician or a DBH-approved entity. Anyone giving personal care must be trained in personal care technique first. Every staff member needs six hours of continuing education per licensure period ⁠². If you accept residents with mental illness or a substance use disorder, the manager and staff need an orientation before the first such resident arrives, then six hours a year of related training ⁠². DBH points new operators to provider training run by OACFA ⁠³.

Ohio sets no numeric staff-to-resident ratio for adult Class Two homes. The rule is need-based ⁠²:

• At least one staff member must be available, on or off site, 24 hours a day, and you must write your minimum staffing pattern into each resident agreement.
• A qualified staff member must be physically present whenever a resident needs help walking, bathing, toileting, dressing or eating, needs ongoing supervision, is non-ambulatory, or has “as needed” (PRN) medication.
• Residents may never supervise or care for other residents.
• A home licensed for five or fewer may briefly leave residents with a background-checked non-staff adult, for no more than four consecutive hours a day and nine hours in 30 days, and that person may not give personal care.

Applying to DBH, step by step

1. Read the rules and pick your class

   Confirm Class Two fits, decide your maximum residents and household members, and decide whether you will serve people with mental illness. The application must state all three ⁠².

2. Clear zoning and get your certificate of use

   DBH’s toolkit puts this first ⁠⁴⁠⁵.

3. Collect inspections

   Get the fire inspection, then either the electrical and heating inspections (five or fewer household members) or the building inspection or certificate of occupancy (six or more), plus a well and septic inspection if needed ⁠².

4. Complete background checks

   for every owner, operator, manager, employee and non-resident occupant ⁠².

5. Submit the application

   Send it to DBH with the $75 fee, a line drawing or description of all resident and staff areas, any written waiver or variance request, and the adverse-action disclosure. Each home needs its own application ⁠²⁠⁴⁠⁶. The toolkit also supplies sample budget, asset and liability, and projected revenue and expense forms, but OAC 5122-30-04 does not list them among the application contents ⁠²⁠⁴. DBH will not review an application unless the fee is included ⁠⁴. DBH’s Class Two pages do not list an initial application form or a submission method; they say only that licenses are renewed every two years in the Licensure and Certification Tracking System (LACTS) ⁠¹³. Call the Bureau of Licensure and Certification at 614-752-8880 and ask which form and channel it accepts for a first license.

6. DBH sends a copy to the county board

   DBH forwards the application to the county’s alcohol, drug addiction and mental health services (ADAMHS) board, which can send comments ⁠¹. If you will serve residents with mental illness, the rule also has you send the board a copy ⁠².

7. Completeness review

   DBH checks the file. An incomplete application is treated as never filed, and DBH will either list the corrections or return it ⁠².

8. On-site inspection and operator interview

   DBH inspects the house before occupancy and interviews the proposed operator about their ability to supervise and give personal care ⁠²⁠⁴. DBH may require a written plan of correction for fixable deficiencies ⁠². DBH now posts survey findings and takes plans of correction through its SansWrite platform ⁠³.

9. License issued, then admissions

   You may not admit anyone until you hold the license ⁠². The license names the class and the maximum number of residents and household members, must be posted where residents and visitors can see it, and cannot be transferred to another address or owner ⁠².

DBH answers waiver or variance requests within 30 days, and a waiver cannot last past the current license’s expiration ⁠². Neither the statute nor the rules give a processing time for a new license.

What it costs, as DBH published it

Renewal applications must include the same materials as an initial application, and those materials include the licensure fee ⁠². You also pay for every inspection yourself ⁠². DBH’s 2019 toolkit worked through a three-resident example: it listed a $60 certificate of use and estimated $4,375 to $6,997 in startup costs, while warning that rent and other lines vary widely ⁠⁴. Treat those as DBH’s 2019 illustration, not as current prices.

Running the home: agreements, care plans and reports

• Resident agreement. Required for each resident. It must list monthly charges and itemized fees, refund and deposit terms, your staffing pattern, house rules, and your visitation and roommate policies. It must give 30 days’ written notice before rates rise. Neither the operator nor staff may act as a resident’s payee ⁠².
• Personal care plan. Due within 14 days of admission. If a resident needs a personal care service you do not offer, you must arrange and pay for it or transfer the resident within 14 days ⁠².
• Meals. Three balanced meals a day, a snack if more than eight hours pass between dinner and breakfast, a one-week supply of staples and a two-day supply of perishables, and 30 days of past menus on file. You need a food service license only if you cook for two or more homes with more than sixteen residents combined, or for off-site locations ⁠².
• Incidents. Forward reportable incidents to DBH within 24 hours, not counting weekends and holidays ⁠².
• Grievances. Post a written grievance procedure and the name of the resident rights advocate. Resolve grievances within 21 calendar days unless extenuating circumstances are documented, and keep the records three years ⁠². Long-term care ombudsman representatives may enter Class Two homes serving three to sixteen adults or RSS residents at any time ⁠¹.
• Discharge. Give the resident, their county board and their case manager 30 days’ written notice of a transfer or discharge ⁠².
• Side businesses. Get DBH’s written approval before running any for-profit activity in the house, such as babysitting or renting a room to a non-resident ⁠².
• Extra guests. Tell DBH in writing before anyone stays more than 48 hours beyond the household limit on your license. Such stays are capped at 14 days a year ⁠².

Renewal, inspections and enforcement

A full Class Two license is valid for two years from issue (Class One licenses run three) ⁠². The statute allows up to three years ⁠¹. A complete renewal must reach DBH 90 days before expiration. If DBH has received no renewal application by the expiration date, the license terminates, and termination is not appealable as a denial ⁠². A renewal needs a current annual fire inspection and, unless the home holds a building inspection or certificate of occupancy that exempts it, a heating and cooling inspection from the 12 months before the renewal application ⁠². DBH’s page says licenses are renewed in LACTS ⁠¹³.

DBH can inspect before licensing and renewal, after a complaint, or at any time, unannounced, with access to all records and residents ⁠¹⁠². It can switch a full license to probationary, which bars new admissions ⁠². It can also suspend admissions, refuse renewal or revoke a license for rule violations, a pattern of noncompliance, false information, or unqualified staff ⁠¹. Once DBH starts one of those actions, you do not get the chance to submit a plan of correction ⁠¹. Under House Bill 96, DBH can now also act on an adverse action from another regulator within three years of learning about it ⁠¹⁠⁸.

Getting paid: the Residential State Supplement

The public payment program built around Class Two homes is the Residential State Supplement (RSS), which tops up the SSI or Social Security income of aged, blind or disabled adults ⁠¹⁰. Under OAC 5122-36, a person qualifies only if they ⁠⁹:

• are 18 or older and meet at least a protective level of care;
• need no more than 120 days of skilled nursing in any twelve months (the limit does not apply in a licensed residential care facility authorized to provide skilled nursing);
• do not need someone present 24 hours a day to prevent harm because of a cognitive impairment;
• are not related to the owner or caregiver;
• are not in a federal waiver program, PACE or a Medicare- or Medicaid-certified hospice.

The person must also live in, or be accepted by, a DBH-licensed Class Two facility in good standing. An ODH residential care facility or assisted living program qualifies only if the county has no Class Two homes, or none with open beds that house people with mental illness ⁠⁹⁠¹².

DBH reviews the non-financial criteria, and the county job and family services office then decides financial eligibility. Approved applicants are either enrolled or put on a wait list ⁠⁴⁠⁹. For RSS residents, the resident agreement must keep the monthly charge for room, board, supervision and personal care within the limit set in OAC Chapter 5122-36 ⁠². OAC 5122-36-05, effective July 1, 2023, sets the allowable fee, the most an RSS recipient pays a living arrangement, at $1,600 per month, and a personal needs allowance of at least $200 per month; the RSS payment itself is calculated under OAC 5160:1-5-01(G) ⁠⁹. A home that takes RSS residents must accept that fee as payment in full for accommodations, supervision and personal care ⁠⁹. Ask DBH or the county job and family services office what the supplement pays for a given resident, since the rules do not set one figure.

What changed recently

• September 30, 2025: House Bill 96 renamed OhioMHAS the Department of Behavioral Health. It extended adverse-action reporting to subsidiaries of the facility, owner or operator, and let DBH deny, refuse to renew or revoke a license over a recent adverse action ⁠¹⁠⁸.
• ORC 5119.345 (effective September 30, 2025) requires DBH to publish an online directory of every licensed residential facility, with its name, address, class and services ⁠⁷. Expect your home’s address and class to be public.
• The core operating rules in OAC Chapter 5122-30 have been in effect since January 1, 2018. The background check rule took effect October 1, 2020, and the transfer and discharge rule November 21, 2020 ⁠². The chapter’s rules list a five-year review date of June 30, 2023 ⁠², so watch DBH’s rule notices for a rewrite.

If you are also weighing a child care business, Ohio’s Department of Children and Youth handles those licenses: see the family child care home and child care center guides.

Sources

1. 1
   Ohio Legislative Service Commission (codes.ohio.gov), Ohio Revised Code 5119.34: Residential facilities Checked 12 Oct 2026 · Back to text ↑
2. 2
   Ohio Legislative Service Commission (codes.ohio.gov), Ohio Administrative Code Chapter 5122-30: Residential facilities Checked 12 Oct 2026 · Back to text ↑
3. 3
   Ohio Department of Behavioral Health, Residential Facility Class 2 Checked 12 Oct 2026 · Back to text ↑
4. 4
   Ohio Department of Behavioral Health, Starting Your Residential Facility Class 2: Small Business Toolkit (2017, revised May 2019) Checked 12 Oct 2026 · Back to text ↑
5. 5
   Ohio Legislative Service Commission (codes.ohio.gov), Ohio Revised Code 5119.341: Residential facility as permitted use in residential districts Checked 12 Oct 2026 · Back to text ↑
6. 6
   Ohio Legislative Service Commission (codes.ohio.gov), Ohio Revised Code 5119.343: Notice of adverse actions Checked 12 Oct 2026 · Back to text ↑
7. 7
   Ohio Legislative Service Commission (codes.ohio.gov), Ohio Revised Code 5119.345: Directory of residential facilities Checked 12 Oct 2026 · Back to text ↑
8. 8
   Ohio Legislative Service Commission, H.B. 96 (136th General Assembly) bill analysis, Department of Behavioral Health, as passed by the Senate Checked 12 Oct 2026 · Back to text ↑
9. 9
   Ohio Legislative Service Commission (codes.ohio.gov), Ohio Administrative Code Chapter 5122-36: Residential state supplement program Checked 12 Oct 2026 · Back to text ↑
10. 10
    Ohio Legislative Service Commission (codes.ohio.gov), Ohio Revised Code 5119.41: Residential state supplement program Checked 12 Oct 2026 · Back to text ↑
11. 11
    Ohio Legislative Service Commission (codes.ohio.gov), Ohio Revised Code 3721.01: Definitions (nursing homes, residential care facilities) Checked 12 Oct 2026 · Back to text ↑
12. 12
    Ohio Department of Mental Health and Addiction Services (now Department of Behavioral Health), Residential State Supplement (RSS) Eligible Living Arrangement Approval Procedure Checked 12 Oct 2026 · Back to text ↑
13. 13
    Ohio Department of Behavioral Health, Residential Facility Class 2: Path to Licensure Checked 12 Oct 2026 · Back to text ↑

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