Pennsylvania adult day center license: Older Adult Daily Living Center rules and steps

Who needs the license

Pennsylvania licenses adult day care through the Department of Aging, not the Department of Human Services or the Department of Health. The governing law is the Older Adult Daily Living Centers Licensing Act (62 P.S. §§ 1511.1-1511.22), carried out by 6 Pa. Code Chapter 11 ⁠¹. The regulation defines an older adult daily living center as premises, run for profit or not, where older adult daily living services are provided simultaneously to four or more clients who are not relatives of the operator for part of a 24-hour day ⁠¹. The Department’s FAQ states the same test for when a license is required ⁠².

Two parts of that definition decide most borderline cases:

• “Simultaneously.” The count is clients present at the same time, not total enrollment ⁠¹.
• “Relatives.” The regulation lists them: spouse, parent, child, stepparent, stepchild, grandparent, grandchild, brother, sister, half brother, half sister, aunt, uncle, niece or nephew ⁠¹. Cousins and in-laws are not on the list.

The rules apply to centers serving people with a functional impairment who are 60 or older, or 18 or older with post-stroke dementia, Parkinsonism or a dementia-related disease such as Alzheimer’s ⁠¹. They cover for-profit, nonprofit, publicly funded and privately funded centers, including centers on the grounds of certain residential programs for people with intellectual disabilities or mental illness ⁠¹. Clients must be screened as needing a structured program and must be capable of being transported to and from the center; a person who is bedfast may not be admitted or retained ⁠¹.

Chapter 11 does not apply to ⁠¹:

• Vocational facilities under 55 Pa. Code Chapter 2390 and partial hospitalization programs under Chapter 5210.
• Summer recreation programs, camping programs and socialization clubs.
• Adult day care in a nursing home that serves only the nursing home’s own clients.
• Adult developmental training facilities run by the Department of Human Services (formerly Public Welfare) or the Department of Education.

Avoid confusing this license with three others. A program for adults 59 or younger without a primary dementia diagnosis is licensed by the Department of Human Services as an adult training facility under 55 Pa. Code Chapter 2380 ⁠¹⁶; the Medicaid waiver lists it as a separate “Adult Day Center” provider type from the Department of Aging center ⁠¹¹. An adult training facility that serves four or more clients aged 60 or older must also hold the Department of Aging license, and the Department counts over 100 such dually licensed centers ⁠¹⁶. Under Aging Program Directive 26-20-03 (September 10, 2026, replacing APD 14-20-01), a dually licensed facility that primarily serves people without a primary dementia diagnosis may ask the Department of Aging to waive its own inspections (§§ 11.241-11.242), leaving onsite oversight to DHS; it still files the application and fee every year with an attestation of Chapter 11 compliance, and a facility newly serving older clients must first pass one Department of Aging inspection and receive a regular license ⁠¹⁶. Overnight care for four or more adults falls under a personal care home license or an assisted living residence license, and care in clients’ own homes falls under a home care agency license. Other states’ rules for this business type are compared on the adult day care license page.

Running a center without the required license is a summary offense: a fine of $50 to $300 plus costs on conviction, with each day counted as a separate offense ⁠¹.

Before you sign a lease: the I-4 occupancy problem

Check the building’s occupancy classification first. The Department requires a certificate of occupancy showing use group I-4 to operate a center, and the final certificate goes in with the application ⁠²⁠⁴. Aging Technical Assistance Bulletin 26-20-02 (September 10, 2026) quotes the International Building Code definition of I-4 as a facility giving supervision and personal care for less than 24 hours to more than five unrelated adults, and applies the I-4 requirement to new centers and to existing centers that renovate or relocate; centers licensed before July 2004 under the older “A”, “B” or “C” codes may keep operating under them ⁠¹⁵. The bulletin tells applicants to contact the local zoning inspector or the Department of Labor and Industry at (717) 787-3806 to schedule the occupancy safety inspection ⁠¹⁵. The regulation names the issuing authorities as the Department of Labor and Industry or, in their cities, the Pittsburgh Department of Public Safety, the Philadelphia Department of Licensing and Inspection, or the Scranton Department of Community Development ⁠¹. The Department adds that more than 90% of Pennsylvania municipalities enforce the Uniform Construction Code locally, so in most places the local code office issues it ⁠². If you later remodel, you need a new permit or written approval if the issuing office requires one, and if a permit is withdrawn or restricted you must tell the Department orally within one working day and in writing within two ⁠¹.

The Department’s pre-application checklist (dated July 25, 2011) asks the same question first under site selection, along with whether the building is ADA compliant and whether a co-located center has its own space ⁠⁶.

Size the space before you sign. Licensed capacity comes from at least 50 square feet of indoor program space per client, measured wall to wall ⁠¹⁠². Bathrooms, dining areas, kitchens, hallways, offices, first-aid rooms and loading docks do not count unless you document that the space is used for programming at least 50% of each program day; permanent storage never counts ⁠¹. A center inside a building with other services needs its own identifiable space during its hours, except that it may share with an adult developmental training facility licensed by the Department of Human Services or Education ⁠¹⁠².

The physical-site rules then add ⁠¹:

• One toilet and one sink for every 14 clients present, and two separate bathrooms once you serve 15 or more at a time (for centers licensed after October 12, 1993). If any client has a physical disability, at least one accessible toilet stall large enough for a wheelchair transfer with a staff member.
• A first-aid area screened off from program space, with a bed, reclining chair or cot, and a first-aid kit on each floor.
• Hot water no hotter than 130°F where clients can reach it; indoor temperature at least 70°F while clients are present, with fans or air conditioning once it passes 80°F.
• Office space, storage, private space for confidential consultation, and a loading or parking area for arrivals and departures.
• A written sewage approval from the municipal sewage enforcement officer if you are not on public sewer, and water tests under 25 Pa. Code Chapter 109 if you are not on public water. The application checklist asks for a water and sewer bill as proof of public connection ⁠⁴.

Fire safety requirements in §§ 11.81-11.91 include an alarm audible throughout the building (repaired within two working days if it fails), a 2-A fire extinguisher on every floor plus one per additional 5,000 square feet, a 10-B extinguisher in each kitchen, exit signs with letters at least 6 inches high, fire drills at least every six months on varying days and times, and an annual onsite fire safety inspection by the local fire department or another fire safety authority ⁠¹. A copy of that inspection is part of the initial application ⁠⁴.

Staffing, qualifications and training

Chapter 11 sets one numeric ratio: at least one program staff member for every seven clients at all times ⁠¹. “Program staff” means employees who directly assist clients or provide services; people who mostly do housekeeping, maintenance, bookkeeping or clerical work do not count, and neither does a nurse or social worker retained only as a consultant ⁠¹. Staff must be close enough to respond immediately, and the program director must name someone to run the center in the director’s absence ⁠¹.

The center must fill four roles, though one person can hold several if qualified for each ⁠¹:

Nursing time is flexible by rule: it can range from a daily RN on staff to a monthly or quarterly LPN visit, depending on clients’ needs, but the nurse must carry out standard nursing reviews at least quarterly ⁠¹. The application checklist asks for the nurse’s license and resume; if the nurse is an LPN, the name of the directing RN or physician; and for a contracted nurse, proof of that nurse’s professional liability insurance ⁠⁴.

Training rules ⁠¹⁠⁷:

• General orientation in 13 listed areas within three months of hire, and training on client needs, body mechanics, abuse reporting and behavior management within three months and every year after.
• At least two more training sessions totaling at least 8 hours a year.
• At least one staff member certified in CPR and first aid present at all times.
• The Department’s online director training (about 4.25 hours) for every director and every person who runs the center in the director’s absence; newly hired directors must finish it within three months. The hours count toward the § 11.33 annual training ⁠⁷. You register for it with the application ⁠⁴⁠⁷.

Staff who touch clients or handle food need a physical within 12 months before hire and every two years after, including a TB skin test within the prior two years ⁠¹. Medications that clients do not take themselves must be given by a licensed professional (physician, dentist, physician assistant, CRNP, RN or LPN), or, for oral, topical and eye or ear prescriptions only, by staff who passed the Department of Human Services Medications Administration course ⁠¹. The FAQ adds that giving insulin also requires an approved diabetes patient education program ⁠².

Background checks under OAPSA

The regulation’s own background rule (state police check, plus an FBI check for anyone not a Pennsylvania resident for the prior three years) has been overtaken: the Department states that the Older Adults Protective Services Act and 6 Pa. Code §§ 15.141-15.147 supersede Chapter 11’s criminal history requirements ⁠¹⁠². In practice:

• Operators must request their reports before submitting the application, and staff reports before hire, according to the FAQ ⁠². The older AGL-02 instructions say within 48 hours after applying, and § 11.18 says two working days ⁠⁵⁠¹; follow the FAQ and include the reports in the packet ⁠⁴.
• The application must show completion of the online OAPSA training by the director and all management staff ⁠⁴.
• FBI fingerprinting runs through IDEMIA’s PA SafeCheck system; the Department reported the FBI fee rose to $26.20 effective June 15, 2024 ⁠⁸.
• In Peake v. Commonwealth (2015) the Commonwealth Court held OAPSA’s lifetime employment ban unenforceable. Checks are still required, and the Department recommends an individualized, case-by-case assessment of any conviction ⁠⁸.

Separately from OAPSA, Chapter 11 bars staff hired after October 12, 1993 who have a felony or assault-type conviction, a substantiated OAPSA abuse finding, or a Nurse Aide Registry finding ⁠¹.

What the application packet contains

New applications are accepted only by email, to [email protected], with a separate attachment for each regulation or policy ⁠²⁠³⁠⁴. The Department’s Initial Application Checklist (June 28, 2023) says an application is complete only when every item is included; scanned documents and electronic signatures are accepted ⁠⁴. It lists:

1. The three state forms

   AGL-02 Application for License (signed by a corporate officer if the legal entity is a corporation), AGL-07 Provider Self Certification and Civil Rights Compliance, and AGL-08 Center Operations and Demographics ⁠³⁠⁴⁠⁵.

2. Entity papers

   Articles of incorporation or partnership agreement; for a nonprofit, the 501(c)(3) letter; for a for-profit using a name other than the owner’s, the Department of State fictitious name approval; for an out-of-state corporation, authority to do business in Pennsylvania ⁠¹⁠²⁠⁴. AGL-02 also asks for every owner’s name and address and asks whether the entity, owner or operator has ever been denied a license or had one revoked or not renewed, been convicted of a felony, or been named in an indicated or founded abuse report ⁠⁵.

3. Building documents

   The I-4 certificate of occupancy, the fire safety inspection, proof of public water and sewer (or the tests and approvals above), and a floor plan showing exit paths, the use of each area, the dimensions of each program room and every bathroom fixture ⁠⁴.

4. Insurance

   Personal and professional liability coverage, which § 11.22 requires ⁠¹⁠⁴.

5. People

   Director resume and degrees, director training registration, nurse qualifications, activities coordinator and aide qualifications, staff physicals, CPR and first-aid cards, criminal history reports, a staff list with hire dates, and job descriptions ⁠⁴.

6. Program documents

   A training curriculum with trainer qualifications, a service description covering the core services (personal care, nursing, social services, therapeutic activities, nutrition and emergency care), and center-specific policies on admissions, client rights, abuse reporting, incidents, grievances, emergencies and evacuation, care plans, discharge, infection control, medications and records ⁠¹⁠⁴.

7. Meals

   A statement of where meals come from (your kitchen or a named caterer) plus, if your municipality requires them, the county or local kitchen license and food-safety training such as ServSafe, or written confirmation from the local authority that nothing more is required ⁠⁴.

8. Sample forms

   Client rights, fire drill log, intake screening, client physical, enrollment agreement, care plan, staff physical and medication administration record ⁠⁴. The Department posts sample intake, care plan and fire drill forms ⁠³.

A separate application is needed for each center ⁠¹.

From application to interim license

1. Division Chief review

   The Division Chief reviews each new application and answers questions ⁠².

2. Interim inspection

   Once the application is accepted, a Licensing Representative inspects the site; the Department says this generally happens within 3 to 6 weeks of acceptance ⁠². The inspection checks that the premises are safe, that the I-4 certificate of occupancy is valid and that you are likely to comply with Chapter 11 ⁠¹⁴.

3. Interim license

   A first-time applicant at a location receives an interim license if the applicant is suitable, the premises are safe and substantial compliance is likely before it expires. It lasts up to six months and cannot be renewed ⁠¹⁠².

4. First full inspection

   A full inspection takes place before the interim license expires, and the center must have at least one client enrolled when the interim license expires to qualify for it ⁠¹⁴. The Department then issues a 12-month regular license, at most one provisional license of up to six months, or no license; after a denial you can restart the interim process ⁠¹⁠¹⁴. Any cited deficiency needs an acceptable written plan of correction naming who is responsible, the completion date and how recurrence will be prevented ⁠¹⁠².

5. Pay and post

   The fee is due before the license is issued, and the license must be posted in a public place in the center ⁠¹.

The license names the legal entity, location, services, maximum capacity and dates. It is not transferable and becomes void on a change of ownership, location or profit/nonprofit status ⁠¹. You must give the Department 60 days’ notice of such a change and file a new application at least 30 days before it; other changes, such as a new responsible person, are reported within 30 days ⁠¹.

Fees

Section 11.252 sets an annual application or reapplication fee by maximum licensed capacity ⁠¹. As published on October 12, 2026:

The fee schedule has not changed since the chapter took effect on October 12, 1993 ⁠¹. Payment is by check or money order with the Department’s Finance Check Processing Label: you scan and email the check and label to your regional licensing representative for approval, then mail them to the Department’s Bureau of Financial Operations in Harrisburg ⁠⁹. Your real start-up costs lie elsewhere (the I-4 occupancy, fire alarm and bathroom work, insurance, and staff), and the Department publishes no estimate of them.

Running the center: rules inspectors check

Inspectors work from the regulation and the Department’s License Inspection Instrument, which holds its interpretive guidelines for Chapter 11, and inspection summaries are public through the Department’s adult day center directory ⁠². That directory listed 234 centers when checked on October 12, 2026 ⁠¹³. Items that drive citations:

• Intake and enrollment. An intake screening within 60 days before admission; a physical exam within three months before admission and every year after, with a TB test within two years; a signed enrollment agreement stating charges and discharge conditions ⁠¹.
• Care plans. Written within 30 calendar days of admission and reviewed at least every six months with the client or responsible party, plus monthly progress notes ⁠¹⁠².
• Quarterly items. Staff review of emergency procedures, client fire safety training and the standard nursing reviews, each within three months of the last ⁠².
• Meals. One complete meal providing at least one-third of daily dietary allowances for anyone present four or more hours, plus a snack beyond six hours; menus posted a program day ahead and kept two months ⁠¹. Chapter 11 still says cold food at or below 45°F, but the Department’s FAQ says the Department of Agriculture food code (7 Pa. Code Chapter 46) overrides it, so store cold food at or below 41°F and frozen food at or below 0°F ⁠¹⁠².
• Restraints. Restraints, seclusion and aversive conditioning are prohibited, and locked doors that prevent exit count as a restraint ⁠¹.
• Incidents. Abuse, fire department or police incidents are reported orally to the Department within 24 hours (no later than the next working day), with a written report within three working days; a client death needs a written report within 24 hours ⁠¹.
• Records. Client records are kept at least four years after the client leaves ⁠¹.
• Transportation. Drivers must be 18 or older with a valid license, with an aide on board when clients need one ⁠¹.

The Department may grant time-limited waivers of specific rules on its Request for Waiver of Regulation form, reviewed yearly ⁠¹⁠².

Renewal and inspections

A regular license lasts up to 12 months ⁠². Reapply on the Department’s form at least 60 days before any license expires, whether regular, interim or provisional ⁠¹. The Department inspects every center onsite at least once every 12 months; the annual visit is announced in advance and held during business hours, but unannounced visits can happen at any time, and complaint inspections at any hour ⁠¹. A center short of full compliance may get a provisional license of up to six months, no more than three in a row and no more than 18 months in total ⁠¹. Grounds for denial, nonrenewal or revocation include failing to submit or follow a plan of correction, abuse or neglect of clients, fraud in the application, and a felony conviction of the entity, owner, operator or an employee ⁠¹. Appeals follow 6 Pa. Code §§ 3.6-3.11 ⁠¹.

Medicaid and other payers

The Department of Aging’s FAQ is direct about funding: it offers grant opportunities only infrequently and points businesses to the Department of Community and Economic Development. Once licensed, a center may enroll as a Medical Assistance provider and contract with its local Area Agency on Aging or the VA, but contracts do not guarantee referrals, and private-pay marketing is up to you ⁠². The AGL-08 form lists the payers the Department tracks: private pay, OPTIONS, the VA, private insurance, county MH/ID programs, LIFE, and waiver programs ⁠¹⁰.

Medicaid’s main route is Community HealthChoices (CHC), the Department of Human Services’ managed long-term services program. Managed care organizations run it across five zones covering all 67 counties, for people 21 and older who are financially and clinically eligible for long-term services, and LIFE is the alternative for nursing-facility-eligible people ⁠¹¹. The CHC 1915(c) waiver (amendment effective July 1, 2026) covers Adult Daily Living in two tiers ⁠¹¹:

• Basic Adult Daily Living, delivered in a licensed center under the Chapter 11 core services.
• Enhanced Adult Daily Living, which adds an RN on site one hour a week for each enrolled waiver participant (each seen at least every other week), a 1:5 staff ratio, at least 11 hours open each weekday to qualify for the Enhanced rate, and the specialized therapy and medical services described in § 11.402. Once a center is certified Enhanced, every participant counts as Enhanced.

Billing is one day for four or more hours and a half day for fewer than four ⁠¹¹. To qualify, a Department of Aging center must hold its Chapter 11 license, have a waiver provider agreement under 55 Pa. Code Chapter 1101, follow the provider rules in 55 Pa. Code Chapter 52, meet the federal home and community-based settings rule (42 CFR 441.301(c)(4)-(5)), carry commercial general liability, workers’ compensation and auto insurance for vehicles used in the service, and have its service location in Pennsylvania or a bordering state ⁠¹¹. Waiver staff must be 18 or older with a high school diploma or GED, one year of relevant experience and OAPSA clearances ⁠¹¹. The waiver does not publish rates, and this guide gives none.

Recent changes and what is pending

• June 28, 2023: the Department issued the current Initial Application Checklist, and new applications are accepted by email only ⁠³⁠⁴.
• June 15, 2024: the FBI fingerprint fee for OAPSA checks rose to $26.20 ⁠⁸.
• July 1, 2026: CHC waiver amendment PA.0386.R05.01 took effect; it contains the Basic and Enhanced Adult Daily Living definitions above ⁠¹¹.
• September 10, 2026: the Department of Aging reissued its interim licensure bulletin (ATAB 26-20-01), certificate of occupancy bulletin (ATAB 26-20-02) and dual-licensing directive (APD 26-20-03), replacing the 2006 and 2014 versions with minimal changes ⁠¹⁴⁠¹⁵⁠¹⁶. The Department’s application page still links the old APD 14-20-01, which no longer opens ⁠³.
• Pending, CHC re-procurement: the Office of Long-Term Living issued a Request for Information on June 1, 2026 and published a summary of over 200 responses, including one from the Pennsylvania Adult Day Services Association, on October 5, 2026. It says the comments will shape a new Request for Application for the CHC managed care plans ⁠¹². Watch it if Medicaid is part of your plan, since those plans hold the contracts.

The Chapter 11 rules themselves date from October 12, 1993 and show no later amendments in the Pennsylvania Code ⁠¹. Some Department guidance is newer, so check the FAQ and the application page when you apply.

Sources

1. 1
   Pennsylvania Code and Bulletin (Legislative Reference Bureau), 6 Pa. Code Chapter 11: Older Adult Daily Living Centers Checked 12 Oct 2026 · Back to text ↑
2. 2
   Pennsylvania Department of Aging, Adult Day Center Frequently Asked Questions for New and Existing Centers Checked 12 Oct 2026 · Back to text ↑
3. 3
   Pennsylvania Department of Aging, Apply for Adult Day Center Licensing Checked 12 Oct 2026 · Back to text ↑
4. 4
   Pennsylvania Department of Aging, Licensing Division, Initial Application Checklist for an Older Adult Daily Living Center License (June 28, 2023) Checked 12 Oct 2026 · Back to text ↑
5. 5
   Pennsylvania Department of Aging, Application for License (AGL-02) and instructions Checked 12 Oct 2026 · Back to text ↑
6. 6
   Pennsylvania Department of Aging, Pre-Application Checklist (July 25, 2011) Checked 12 Oct 2026 · Back to text ↑
7. 7
   Pennsylvania Department of Aging, Register for Adult Day Center Online Director Training Checked 12 Oct 2026 · Back to text ↑
8. 8
   Pennsylvania Department of Aging, Criminal History Background Checks Checked 12 Oct 2026 · Back to text ↑
9. 9
   Pennsylvania Department of Aging, Licensing Division, Finance Check Processing Label Checked 12 Oct 2026 · Back to text ↑
10. 10
    Pennsylvania Department of Aging, Center Operations and Demographics Form (AGL-08), September 30, 2016 Checked 12 Oct 2026 · Back to text ↑
11. 11
    Pennsylvania Department of Human Services, Application for 1915(c) HCBS Waiver PA.0386.R05.01: Community HealthChoices (effective July 1, 2026) Checked 12 Oct 2026 · Back to text ↑
12. 12
    Pennsylvania Department of Human Services, Office of Long-Term Living, Comments on Community HealthChoices Request for Information: Summary of Public Comments (October 5, 2026) Checked 12 Oct 2026 · Back to text ↑
13. 13
    Pennsylvania Department of Aging, Adult Day Centers Checked 12 Oct 2026 · Back to text ↑
14. 14
    Pennsylvania Department of Aging, Aging Technical Assistance Bulletin 26-20-01: Interim Licensure Process for Older Adult Daily Living Centers (September 10, 2026) Checked 12 Oct 2026 · Back to text ↑
15. 15
    Pennsylvania Department of Aging, Aging Technical Assistance Bulletin 26-20-02: Certificate of Occupancy Code for Older Adult Daily Living Centers (September 10, 2026) Checked 12 Oct 2026 · Back to text ↑
16. 16
    Pennsylvania Department of Aging, Aging Program Directive 26-20-03: Older Adult Daily Living Centers Dually Licensed as an Adult Training Facility (September 10, 2026) Checked 12 Oct 2026 · Back to text ↑

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