Overview
The Department of Human Services (DHS) is responsible for all human services programs for providers and partners across the Commonwealth.
The Application for Certificate of Compliance, or the HS 633 form, is used to apply for a license to become a provider of human services programs.
Services Requiring Licensure
The following specialized services require the completion of the HS 633 form to become a licensed provider.
Long-Term Care
- Personal Care Homes (PCH)
- Assisted Living Residences (ALR)
Child, Youth, and Families Facilities
- Adoption Services
- County Children and Youth Agency
- Day Treatment Program
- Foster Family Care Agency Services
- Professional Foster Care Services
- Group Day Care Home
- Mobile Programs
- Non-Secure Residential Services
- Outdoor Program
- Private Children and Youth Agency
- Residential Child Care Facility
- Secure Care Program
- Secure Detention Facilities
- Supervised Independent Living Program
- Transitional Living Program
- Secure Residential Services
Mental Health Facilities
- Assertive Community Treatment (ACT)
- Community Residential Rehabilitation Service
- Crisis Intervention Programs
- Family Based Services
- Intensive Behavioral Health Services
- Long-Term Structured Residence
- Partial Hospitalization
- Peer Support
- Private Psychiatric Hospital
- Psychiatric Rehabilitation Facility
- Psychiatric Unit
- Residential Treatment Facilities Adults
Services That Do Not Require the HS 633
The Office of Child Development and Early Learning (OCDEL) and Office of Developmental Programs (ODP) do not utilize the HS 633. Please visit the Early Childhood Education website and MyODP.com for more information.
If your facility or agency is operated by a corporation, LLC, LP, etc., a copy of the Department of State’s approved papers must be included.
If the legal entity is for profit and wishes to name the home something other than the owner’s or corporation’s, LLC’s, or other entity’s name, then a copy of the Department of State’s approved fictitious name papers must be included.
If the legal entity is a corporation, LLC, LP, etc., formed in a state other than Pennsylvania, then a copy of the Department of State’s approved authorization to do business in Pennsylvania must be included.
If applicable, in the form of a copy of the IRS letter of approval of non-profit status or the PA Department of Treasury’s approval of non-profit status.
Licensing Resources
Additional Documents
- Initial Application Checklist for a Certificate of Compliance for Human Service Settings
- HS 2126: Civil Rights Compliance Form (New Providers)
- HS 2125: Civil Rights Compliance Attestation Form (Renewals)
Human Services Licensing Laws
Fire Safety Approval (Certificates of Occupancy)
Application Process
To submit your HS 633 form, make sure to complete the following steps.
- Your application must be signed by the owner if a corporation or a corporate officer.
- A copy of the final and approved occupancy permit, if require d, must be included issued by the Department of Health, Department of Labor and Industry, or a local municipality. The address on the occupancy permit must match the address on the application.
Civil rights compliance approval is required. prior to issuance of Certificate of Compliance. The Civil Rights Compliance Form (HS2126) must be submitted with the application (HS633).
Application Fee
Application fees only apply to personal care homes and assisted living residences. Fees vary depending on the number of beds the facility contains.
Personal Care Homes
- 20 beds or less: $10
- 21-50 beds: $20
- 51-100 beds: $30
- 101 beds and over: $50
Assisted Living Residences
- $300 — No Special Care Unit
- $450 — With a Special Care Unit
- $35 — Per Bed Fee (requested when the Certificate of Compliance is issued)
Payment Options
The licensing administration now accepts electronic payment for renewal applications, Certificates of Compliance fees and Fines or Appeals payments through Snap-Pay. (Initial/New application fees must be sent via check or money order ONLY.)
Return Your Application
For Initial applications with an application fee only — Once you have completed your application, you can send it to the Department of Human Services’ Licensing by mail at the following address:
Department of Human Services
Human Services Licensing
Room 623
P.O. Box 2675
Harrisburg, PA 17105-2675
Initial applications for the following Program Offices can be emailed to the Office of Children, Youth and Families (OCYF) or the Office of Mental Health and Substance Abuse Services (OMHSAS).