Starting a care business in Arkansas

Child care licensing is now enforced by the Office of Early Childhood (OEC), although the published rules still name the old DHS child care division. In your own home, you need a license once you care for 6 or more children from more than one family at the same time. Your own preschoolers count toward that number, and the license caps the home at 16 children. Below that, a home may join the voluntary registry (the registered-home rule says 5 or fewer children, OEC's page says fewer than 5, so ask OEC about exactly five). A licensed child care family home pays $15 a year and needs $100,000 of liability insurance. A child care center is any program open more than 5 hours in a day or 10 hours in a week. Its annual fee runs from $15 to $100 by capacity, and it needs $500,000 of insurance per occurrence ($1,000,000 at 75 children or more). Both start with a pre-licensing class and a provisional license that lasts up to 12 months.

The Permit of Approval shapes adult residential care. An assisted living facility is licensed at Level I or Level II and is required once you serve more than 3 adults who are not related to the owner or administrator. Before DHS will license one, the Permit Agency must approve the beds. It reviews applications in quarterly cycles (due February 1, May 1, August 1 and November 1) for a $3,000 fee and tests them against a need formula of 30 beds per 1,000 residents aged 65 or older. The October 2026 Bed Need Book shows a statewide net need of 8,609 beds, but Dallas, Hempstead and Nevada counties are negative. Buying an existing facility does not require a permit.

A residential care facility gives room, board and daily-living help to 3 or more adults who need no daily nursing care. Since July 1, 2005, no applications have been accepted for new RCFs or extra RCF beds. The Office of Long Term Care licenses no adult family home or small care home category, so even a house taking in three paying adults appears to fall inside the RCF definition and the moratorium. In practice, the way in is buying a licensed RCF through a change of ownership. An adult day care license from DHS needs no permit and costs $5 per slot on a July-to-June license year. It covers 4 or more functionally impaired adults for more than 2 and less than 24 hours a day. However, since Act 905 of 2021 the law has excluded programs of 12 or fewer from the long-term care facility definition, so get DPSQA's answer in writing if your program is small.

In-home care runs through the Department of Health's Health Facility Services. The private care agency license is written for Medicaid personal care: Act 853 of 2025 defines these agencies by whether they seek Arkansas Medicaid reimbursement, and the rule requires $1,000,000 of liability insurance. No official source says whether a private-pay companion or homemaker service needs any license, so ask Health Facility Services. A home health agency also needs a Permit of Approval first. The October 2026 Bed Need Book counts 427 agencies serving whole counties against 208 allowed, and only Phillips and Union counties show a need for one more. Class A licenses are reserved for Medicare-certified agencies, and Arkansas Medicaid home health enrolls only Class A agencies. On May 13, 2026, CMS began a six-month nationwide moratorium on Medicare enrollment of new home health agencies, which it can extend.

Several rules are changing. The DHS rule on criminal record checks for long-term care employees (20 CAR Part 404) was repealed effective July 1, 2026, and the sources checked do not name a replacement. Amendments to the home health and private care agency rules closed for public comment on August 4, 2026 but were still listed as proposed on October 12, 2026. Confirm the version in force with the licensing office before you file.