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Child and Residential Care Facilities Division
Letter of CPA Licensure Renewal Application

Child and Residential Care Facilities Division
825 North Capitol Street, NE
2nd Floor
Washington, DC 20002
Phone: (202) 442-5929
Fax: (202) 442-4831
or (202) 442-9430

All Fields Required

Re: CPA License Renewal Application

Dear :

The license under which is operating as a child-placing agency (CPA) will expire on . To assist you in keeping this license current, the Health Regulation Administration, Child and Residential Care Facilities Division (HRA/C&RCFD) is enclosing a CPA license renewal application for your use.

The inspection of your agency for licensure compliance cannot be conducted until the C&RCFD has received a complete application. The application is deemed complete when all information is filled out, a license fee in the amount of $350.00 has attached, and the required documents have been submitted.

Please return the completed application by  . Failure to return the completed application on or before the indicated date will impede the timely inspection and issuance of licensure for your child-placing agency.

Following receipt of a completed application, a Social Worker form the C&RCFD will conduct an unannounced on-site inspection to make a determination of regulatory compliance in accordance with Title 29 of the District of Columbia Municipal Regulations (DCME), Chapter 16, Standards of Placement, Care and Services for Child-Placing Agencies. The on-site inspection for your agency will take place within ninety (90) days before the license expires.

If you have any questions regarding the above, please call:

Helen Jordan, MSW, CPM
Supervisory Social Worker
Child and Residential Care Facilities Division
(202) 442-5929