Starting a care business in New Jersey

Child care starts with a head count. With five or fewer children under 13 in your own home, you do not need a license, but you can register through your county Child Care Resource and Referral agency for $25 per three-year term. A family child care registration is what makes the home a protected residential use under state zoning law and opens the door to Child Care Assistance Program (CCAP) payments. Once you have a sixth child, even in your own house, you need a child care center license from the DCF Office of Licensing. That license is applied for through NJCCIS at least 45 days before opening and costs $110 to $250 for three years, depending on capacity (as published on October 12, 2026).

Residential care for adults has two sizes. Up to three unrelated adults can live in a caregiver's own home under an adult family care caregiver license. That license has existed only since N.J.A.C. 8:43B took effect on March 6, 2023, and it cannot be issued unless you have a signed contract with a DOH-licensed sponsor agency. Four or more residents means an assisted living residence license under N.J.A.C. 8:36. A new residence needs an expedited-review certificate of need on form CN-19 first; the fee is $7,500, plus 0.25% of total cost for projects over $1,000,000. The project must also commit to filling 10% of its beds with Medicaid-eligible residents within three years of licensure. Only licensed assisted living residences and comprehensive personal care homes may call what they offer "assisted living", and a new comprehensive personal care home is allowed only for narrow conversion and expansion projects. Dementia care homes have their own DOH chapter, N.J.A.C. 8:37.

In-home care is split by who regulates it. An agency that places companions, personal care aides or other caregivers in the homes of people 60 or older or with a disability registers as a health care service firm with the Division of Consumer Affairs. The rules treat it as a type of employment agency, and companion-only agencies have been covered since February 1, 2016. The initial application needs a $500 fee, a $10,000 bond, $1,000,000 in professional liability insurance and a New Jersey RN or physician as supervisor. Accreditation is due at renewal, and registrations now expire September 30. A home health agency license from DOH is a different business: it must provide nursing, homemaker-home health aide and physical therapy services, and it needs a certificate of need awarded during a DOH call. DOH cancelled the 2022 call for lack of need and postponed the July 1, 2025 call. As of October 12, 2026 it had not reissued one, so buying an already licensed agency (form CN-7, $1,000 fee, filed at least 90 days before closing) is the route DOH still accepts.

Adult day care is licensed only in its medical form. A center that gives adults preventive, diagnostic, therapeutic or rehabilitative services under medical and nursing supervision needs an adult day health services facility license under N.J.A.C. 8:43F, whether participants pay privately or through Medicaid. It starts with a CN-6 project application, with a fee of $1,500 plus $10 per slot (as published on the January 2024 form). Social-only programs do not appear on DOH's list of licensed facility types. New Jersey has frozen new adult day health licenses in the past, and no official notice ending the last extension was found, so ask DOH whether it is accepting new CN-6 applications before you sign a lease.