Oklahoma residential care home license: probation first, a licensed administrator, no nursing

The license has no size threshold

Most states let a very small adult home operate without a license, or put it under a lighter tier. Oklahoma does not. Under the Residential Care Act, a residential care home is “any establishment or institution” that provides residential accommodations, food service and supportive assistance to any resident who is not related to the owner or administrator by blood or marriage ⁠¹. The Act sets no minimum or maximum bed count. Section 1-821 states that homes caring for three or fewer residents are subject to the Act. The State Board of Health may write lighter rules for those homes, and it has: Subchapter 21 of OAC 310:680 ⁠¹⁠².

Renting rooms to residents does not get you out of the Act. The definition states that leasing rooms “directly or indirectly” to residents “shall not void” its application ⁠¹. State agencies are barred from knowingly placing, referring or recommending anyone to an unlicensed home ⁠¹.

“Supportive assistance” is broad. It includes housekeeping, help with meal preparation, help with the safe storage, distribution and administration of medications, and help with personal care ⁠¹. OSDH describes the license type this way: a home that may help with meals, dressing, bathing and other personal needs, and may assist with medications, but “cannot provide medical care” ⁠⁴.

The statute excludes these settings from the definition ⁠¹:

• adult companion homes, which are funded and certified by the Department of Human Services for three or fewer adults with developmental disabilities
• group homes, hotels and motels
• residential mental health facilities operated by the Department of Mental Health and Substance Abuse Services (ODMHSAS)
• fraternity and sorority houses, and college dormitories
• VA medical foster homes that care exclusively for three or fewer veterans

Who can live in the home, and when you need a different license

The resident test is the line between this license and the next tier up. Residents “shall be ambulatory and essentially capable of participating in their own activities of daily living, but shall not routinely require nursing services” ⁠¹. “Ambulatory” includes anyone who can move themselves, including in and out of a wheelchair, to all areas of the home ⁠¹. The rules repeat the test and add one allowance. A resident may receive the nursing services they could otherwise get in a private home, provided by an individual or agency qualified under state or federal law ⁠². That means a nursing provider qualified under state or federal law can visit a resident, but the home itself is not set up to give routine nursing.

If you plan to offer nursing supervision or intermittent nursing care, you need an assisted living center license. That license applies to a home serving two or more persons ⁠¹, and OSDH notes that an assisted living center may provide “nursing supervision and intermittent or unscheduled nursing care” ⁠⁴. A daytime-only program for impaired adults falls under the adult day care center license. Helping people in their own homes is licensed separately, as a home care or home health agency or a companion/sitter agency.

A home can span several buildings. Each building must be within 175 feet of the building that houses the main kitchen and dining room, all buildings must have the same owner or operator, and all residents must be able to walk or wheel between them ⁠¹.

The administrator: a Tier 2 license from OSDH

Every residential care home “shall be required to have or employ a licensed administrator” ⁠¹. The statute defines the administrator as the person in charge who spends at least one-third of their full working time supervising the home on site ⁠¹.

The administrator credential changed recently. Laws 2023, chapter 271, effective November 1, 2023, moved long-term care administrator licensing into the State Department of Health. It created two tiers. Tier 2 covers administrators of assisted living, residential care and adult day care facilities, and of intermediate care facilities for people with intellectual disabilities with 16 or fewer beds. The law bars OSDH from requiring a four-year degree for Tier 2, and it makes serving as an administrator without a license or certificate a misdemeanor ⁠¹. Administrators who were already licensed or certified may keep serving under their existing authorization ⁠¹.

As of OSDH’s January 28, 2025 requirements letter, a Tier 2 residential care/assisted living (RC/AL) applicant must ⁠⁷:

• be at least 21 years old
• be a U.S. citizen or qualified alien
• have no barrier offenses under OAC 310:679-10-2.1
• have a high school diploma or GED
• pay a $200 initial licensing fee
• complete an approved training program, unless it is waived through a NAB-accredited degree program or reciprocity
• score at least 75% on the Oklahoma State Standards Exam
• pass the NAB core exam

OSDH tells applicants to apply through its licensing portal before they start an approved training program ⁠⁶. RC/AL licenses do not require an internship ⁠⁶. On OSDH’s approved-program list (updated February 2026), every RC/AL course is run by an outside approved provider. OSDH’s own in-person classes cover the Tier 1, adult day care and ICF/IID tracks ⁠⁹. Administrator licenses expire on December 31 each year and are renewed annually ⁠¹. OSDH’s FAQ lists 16 clock hours of continuing education for Tier 2 RC/AL administrators ⁠⁸.

The Residential Care Act still sets its own training floor for administrators. The certificate course must run at least 50 hours, with at least 15 hours on medication administration, and administrators need at least 16 hours of training every year after that ⁠¹. OSDH must see proof of the administrator’s and direct care staff’s training before it issues or renews a license, and it will not renew a home whose training is incomplete ⁠¹.

OAC 310:680 has not been updated since the 2023 law. It still refers to administrator licensure under 63 O.S. § 330.51, which has since been renumbered to § 1-1949.1. For homes of three or fewer beds, it still calls for an administrator holding a “residential care home administrator’s certificate of training” ⁠². The statute’s Tier 2 definition covers residential care facilities and sets no size exception ⁠¹, but the official sources reviewed do not say whether a three-bed home’s administrator now needs a full Tier 2 license or only the older certificate of training. Ask the Long-Term Care Administrator Licensing Program at (405) 426-8970 before you hire ⁠⁷.

Owner eligibility

The licensee must be at least 21 ⁠¹. No one convicted of a felony connected to running a home or long-term care facility, or to caring for its residents, may be licensed or take part in managing one. If the applicant is a company, the same bar applies to every partner, officer and major stockholder ⁠¹. Each of them signs a notarized affidavit on Form 728 ⁠⁵. Under the rules, applicants must also show they are “of reputable and responsible character” and have “appropriate business or professional experience in dealing with the type of residents in the home” ⁠².

You must file a statement of ownership with every application and renewal. It lists every owner, every person who owns the building, each partner or stockholder with an interest of 5% or more, and any other homes in which the owner has a financial interest. You must also agree to notify OSDH 30 days before any of this information changes ⁠¹.

Picking and preparing the building

The physical plant rules apply to every home, including homes with three or fewer beds ⁠². Settle these points before you sign a lease or buy:

• Building type. Mobile homes “shall not be approved” ⁠².
• Location. The home must be in an area the local fire department serves, next to an all-weather road, and on property that meets local zoning. A zoning approval letter goes to OSDH ⁠².
• Plan review. Construction or remodeling plans need OSDH approval before work begins. Any home that undergoes design changes or construction, and every newly licensed home, must meet the accessibility requirements of Chapter 11 of the 2003 International Building Code ⁠².
• Yard space. A first-time home needs at least 50 square feet of outdoor yard per licensed bed for the first 100 beds, and 25 square feet for each bed beyond that ⁠².
• Dining. A first-time home needs dining seating for every licensed bed ⁠², with at least 15 square feet of dining room per resident ⁠².

Men and women may not share a room, or adjoining rooms without a full floor-to-ceiling partition and a lockable door, unless they are immediate family ⁠². A licensed plumber, a licensed electrician or a municipal building inspector must certify the electrical, heating and plumbing systems. Water must come from a public supply or meet public supply standards ⁠².

If your project needs plan review, the fee is 0.02% of the design and construction cost, with a $50 minimum and a $1,000 maximum. Exception requests, self-certification and courtesy construction inspections cost $500 each, and professional consultation or technical assistance costs $500 for each eight hours of staff time (fees as published in OAC 310:680-5-9, eff. 10-1-17). OSDH has 10 calendar days to decide whether a plan submittal is complete and 45 days to finish the technical review. Final plans must be sealed by an Oklahoma-registered architect ⁠².

Fire safety and emergency plans

The State Fire Marshal (or a designee) inspects residential care homes on a regular basis ⁠¹. You need documented Fire Marshal inspection and approval before OSDH will issue your first license. Homes with more than six beds need a fresh annual approval for each renewal ⁠².

Once open, you must permanently display an evacuation plan in the hallways and sitting room, hold fire drills at least quarterly, and keep a written plan for temporary housing if fire or weather makes the home unusable ⁠². A separate statute requires every residential care home to have an emergency evacuation plan that is coordinated with and on file at the local emergency management agency, and also filed with OSDH ⁠¹.

Staffing and training

For homes of four or more beds, OAC 310:680-11-1 requires ⁠²:

• one person administratively responsible for the home, plus a person in charge on duty whenever residents are present
• at least three-quarters of an hour of staff time per resident per day, based on average daily census
• a signed agreement with a registered nurse consultant, with documentation of the nurse’s use kept in the home
• at least one staff member on site at all times trained in first aid and CPR with a hands-on component
• a new-employee orientation covering abuse and neglect, resident rights, confidentiality, emergencies and job descriptions
• written personnel policies; residents may never supervise other residents

Under the statute, anyone who administers medication must be trained through a technology center school or an institution of higher education ⁠¹. Medication staff must start that training within 90 days of hire and complete at least 15 hours within their first year. All other direct care staff must start 8 hours of in-service training within 90 days and finish it within 12 months. After that, all direct care staff need 8 hours a year ⁠¹. Licensed physicians, RNs and LPNs are treated as meeting the medication training requirement ⁠².

Residential care homes are covered employers under the Long-term Care Security Act. Before an aide starts work providing “nursing care, health-related services, or supportive assistance,” you must arrange a criminal history background check under that Act ⁠¹.

In homes of three or fewer residents, staffing follows “the needs of the residents” rather than the hours-per-resident formula. However, every employee there must hold valid first aid and CPR certification, and anyone who gives medications must be certified through an approved medication administration training (MAT) program ⁠².

Food and medications

The home must offer at least three meals a day, with no more than 14 hours between the evening meal and breakfast. Menus must be posted a week in advance and kept for a year, and the home must keep a three-day food supply on hand ⁠². Residents on physician-prescribed special diets require a contract with a registered or licensed dietitian. Homes licensed for 20 or more beds, or serving special diets, must designate a trained food-service supervisor. Kitchens must follow OSDH’s food rules in OAC 310:257, though residential equipment is acceptable if it holds required temperatures ⁠².

Medication rules are detailed. For small homes, Subchapter 21 requires a locked, well-lit storage area no warmer than 86°F, refrigerated drugs kept at 36°F to 48°F, Schedule II drugs in a separate locked box with an individual count, and charting within an hour of each dose ⁠². A resident may self-administer only after documented monitoring shows they can. Staff must then review the self-administration program at least monthly, including a count of each medication ⁠².

Applying: the real order of steps

1. Confirm your resident population fits

   Residents must be ambulatory and must not routinely need nursing. If they will need nursing supervision, apply for an assisted living center license instead ⁠¹⁠⁴.

2. Get the zoning letter

   Your city or county must state that the address is zoned appropriately for a residential care home. Form 728 requires the letter to state the home’s maximum bed capacity ⁠¹⁠⁵.

3. Line up the administrator

   Your administrator needs an OSDH Tier 2 license, or must be lawfully serving under an earlier credential, and you will attach their certificate and continuing education records ⁠¹⁠⁵⁠⁷.

4. Prepare the building and get inspections

   Obtain plan approval for any construction, a licensed plumber or building inspector report, a licensed electrician or municipal inspector report, and State Fire Marshal approval ⁠²⁠⁵.

5. Sign consultant agreements

   You need a physician (or PA or APRN) agreement for emergency care and clinical consultation, plus pharmacist or RN, and dietitian agreements where they apply. These must be renewed every year ⁠²⁠⁵.

6. Assemble the Form 728 packet

   Include Form 953-B (disclosure of owners, lessee and manager), Form 953-C (detail attachment) and Form 953-E (staffing projection), plus the attachments in the next section. Mark “yes” on Form 728 if you will contract with ODMHSAS. If you market Alzheimer’s or dementia care, attach ODH Form 613 ⁠³⁠⁵.

7. Mail it with the $50 fee

   Make the check or money order payable to OSDH and send it to Health Facility Systems, P.O. Box 268823, Oklahoma City, OK 73126-8823 ⁠⁵.

8. Pass the pre-license inspection

   Before issuing a probationary license, OSDH checks your qualifications and inspects the home. For a new home, it tells you what must be corrected before you accept residents ⁠¹. Any plan of correction must be accepted before licensure ⁠¹.

9. Operate under the 120-day probationary license

   Within the last 30 days of that license, OSDH fully inspects the home again. If the home complies, it receives a regular license ⁠¹.

Form 728 lists these attachments for a probationary application ⁠⁵:

• floor plan drawing
• list of all employees with titles, education, experience, qualifications and copies of licenses
• the applicant’s qualifications and every long-term care home in which the applicant has an interest
• the applicant’s financial statement and a projected budget of revenues and expenses for the first month of operation
• notarized lease, if the home is leased
• resident contract including resident rights, services, rates and separately charged items

Health Facility Systems can be reached at [email protected] or (405) 426-8175 ⁠⁴.

Fees as published on 2026-10-12

License fees are not refundable ⁠¹. The rules list a nonrefundable $75 fee with an application for a regular license ⁠², and Form 728 lists $75 for a renewal license, which equals the statute’s $25 per year over 36 months ⁠³⁠⁵. The statute lists only the $50 probationary fee and the $25-per-year renewal fee ⁠¹. No source reviewed says whether OSDH collects a separate fee when a probationary license converts to a regular license, so ask Health Facility Systems before you mail the packet.

Inspections, renewal and enforcement

A regular license lasts 36 months, must be posted, and covers only the premises named in the application ⁠¹. Under the statute, OSDH must inspect each home at least once a year, announced or unannounced. Refusing entry is grounds for denial or revocation, and for emergency transfer of all residents ⁠¹. The OSDH-posted rule text says at least three inspections a year, with the annual inspection held within 120 days before renewal and at least one inspection unannounced ⁠². The sources reviewed do not say which frequency OSDH applies in practice, so ask Health Facility Systems. The Long-Term Care Ombudsman, or an ODMHSAS case manager, may accompany inspections. Reports are filed with the county Department of Human Services office and with ODMHSAS ⁠¹.

After a violation notice, you have 10 days to submit a plan of correction. Corrections must be made within 30 days, and OSDH can approve 30 more ⁠². OSDH can replace a regular license with a conditional license for up to one year, during which it inspects at least semiannually ⁠². Civil penalties run up to $100 per day, capped at $10,000 for a related series of violations. A licensee who surrenders the license instead of paying a fine is barred from ever getting it back ⁠¹. Other sanctions include resident transfer, a temporary manager and injunctions ⁠¹.

Each renewal packet includes renewed consultant agreements, new plumbing and electrical reports, the administrator’s certificate and continuing education, and Fire Marshal approval ⁠⁵. Adding beds is a modification. It requires a new zoning letter showing the higher capacity, an updated floor plan and Fire Marshal approval ⁠⁵.

When you sell the home, the buyer must apply for its own probationary license, and both buyer and seller must notify OSDH at least 30 days before the transfer ⁠¹. To close, you must give residents and OSDH 90 days’ notice if the closure would displace more than 10% of residents ⁠².

Running the home: resident contracts, money and records

You must sign a written contract with each resident within 120 days of admission. The admission contract must let the resident name a representative ⁠¹⁠². If the home is a resident’s payee, keeping an accounting of that resident’s funds is a condition of licensure ⁠¹. Owners, administrators and operators may not hold life insurance on, or be assigned benefits from, a resident’s life unless they are related ⁠¹.

A home may involuntarily discharge a resident only for medical reasons, safety or nonpayment, and only with at least 10 days’ written notice that explains the right to an OSDH hearing ⁠². You must report fires, unnatural deaths, missing residents, utility failures longer than 8 hours, fractures and injuries needing hospital treatment to OSDH by the next working day ⁠². Your license, your administrator’s name and license, resident rights and the complaint procedure must be posted ⁠².

How residential care homes get paid

OSDH lists no Medicare or Medicaid certification and no certificate of need for this license type ⁠⁴. The application asks whether your home contracts with ODMHSAS, and the statute routes inspection reports to that department and to county human services offices ⁠¹⁠⁵. That reflects the agencies that place residents in these homes. The official sources reviewed do not publish payment rates.

Sources

1. 1
   Oklahoma Legislature, Title 63, Oklahoma Statutes: Residential Care Act (63 O.S. §§ 1-820 to 1-840), Long-term Care Security Act and long-term care administrator provisions (§§ 1-890.2, 1-1925.4, 1-1945, 1-1949.2, 1-1949.3, 1-1950.1) Checked 12 Oct 2026 · Back to text ↑
2. 2
   Oklahoma State Department of Health, OAC 310:680, Residential Care Homes (OSDH-posted rule text, last amended eff. 9-11-22) Checked 12 Oct 2026 · Back to text ↑
3. 3
   Oklahoma State Department of Health, Health Facility Systems (fees, laws, rules and forms) Checked 12 Oct 2026 · Back to text ↑
4. 4
   Oklahoma State Department of Health, Long Term Care Programs in Oklahoma Checked 12 Oct 2026 · Back to text ↑
5. 5
   Oklahoma State Department of Health, ODH Form 728, Residential Care Home License Application (revised 9/28/2021) Checked 12 Oct 2026 · Back to text ↑
6. 6
   Oklahoma State Department of Health, Long Term Care Administrator Licensing Program Checked 12 Oct 2026 · Back to text ↑
7. 7
   Oklahoma State Department of Health, Tier II LTCALP License requirements letter (January 28, 2025) Checked 12 Oct 2026 · Back to text ↑
8. 8
   Oklahoma State Department of Health, Long-Term Care Administrator Licensing Program FAQs (10-2024) Checked 12 Oct 2026 · Back to text ↑
9. 9
   Oklahoma State Department of Health, LTCALP Approved Training Programs (updated 2/2026) Checked 12 Oct 2026 · Back to text ↑

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