Adult Residential License Renewal Procedure

Please be sure to complete all sections of the renewal application.  If a particular section does not apply to the facility please insert N/A.  If all sections of the application are not completed, the application will be returned to the administrator. 

Effective June 20, 2017, providers wanting to send express mail must do so by using either US Postal Services Priority Mail® or Priority Mail Express, not FedEx or UPS.

  1. Adult Residential Care Provider Renewal Application form;
  2. Non-refundable License Renewal Fee;
  3. Proof of Financial Viability to Include: a. A letter of credit issued from a federally insured, licensed lending institution in the amount of at least $100,000 or the cost of three months operation, whichever is less; or b. affidavit of verification of sufficient assets equal to $100,000 or the cost of three months operation, whichever is less (for verification of sufficient assets letter must be notarized);
  4. Current State Fire Marshall Report;
  5. Current Office of Public Health inspection report;
  6. Proof of General Liability Insurance of at least·$300,000;
  7. Proof of Professional Liability Insurance of at least $300,000;
  8. Proof of Workers' Compensation Insurance.

HSS Payment Procedure website: http://new.dhh.louisiana.gov/index.cfm/page/1737

IMPORTANT:

1. Payments & Payment Transmittal form must be submitted to Chase Bank
P.O. Box Below:

LDH Licensing Fee
P.O. Box 62949
New Orleans, LA 70162-2949

2. Documentation, such as the application form, Disclosure of Ownership, OPH reports must be sent to Health Standards Section at:

Health Standards Section
P.O. Box 3767
Baton Rouge, LA 70821-3767