LC-Licensee log in 

Licensing Checklist for Intermediary Service Organization (ISO)

Licensure Application Information

The link below will take you to the system where you can create an account to apply for a new facility or a Change of Ownership (CHOW).

Nevada's Online Health Licensing System (ALiS)

If you already have an existing license and you are just making a change to your license, you can use this system to apply for any of the following:

  • Change of Administrator
  • Change of Suite Number
  • Change of Location
  • Change of Name (facility name only)
  • Change in Corporate Personnel

and more...

    Checklist for Initial (new facility) or CHOW Licensure Applications

     

    For all initial/CHOW licensure applications the following items are required to be uploaded to your application:

    •  Resume for the Administrator
      • Must list and match the administrator's name provided in your application.
    •  Copy of Nevada State Business license from the secretary of state office with your NV ID number
      • Only the Copy of the license will be accepted. No receipts or screenshots from SilverFlume.
      • Must list your registered name with the secretary of state listed in your application.
      • Must list your NV business ID with the secretary of state listed in your application.
    •  Bill of Sale (CHOW only)
      • Should include information about the buyer and seller, the date of the sale, a description of the transaction, the price, and signatures from both parties.
    •  Letter of Governing Body stating the effective date of change and specifying what is changing (CHOW only)
      • (i.e: change of owner from/to)
    •  Lease Agreement
      • All Licensed facilities must have a physical location in the State of Nevada.
      • Must list your facility name, facility physical address, proof that you are allowed to run the facility from that location, and must be fully executed.
    •  Articles of Organization (for LLCs only)
      • Must list your LLC name, the names of the officers, and the Nevada Business ID number.
    •  Operating Agreement (for LLCs only)
      • Must list your LLC name and by fully executed.
    •  Articles of incorporation (for corporations only)
      • Must list your corporation's name, the names of the officers, and the Nevada Business ID number. 
       
    •  Governing Body Bylaws (for corporations only)
      • Must list your corporation's name and be fully executed.
    •  Partnership Agreement (if applicable only)
    •  3-Year Business History
      • Provide either the owner(s) resume proving 3 years of owning the same type of facility
      • Or if that doesn't apply, provide the resume and 1 letter of reference for each owner.
    •  Certificate of Liability Insurance (COI)
      • Must list facility name and physical address in the "Insured" box
      • Must have insurance complete the occurrence and amount information.
      • Must have "certificate holder" box list the Division of Purchasing and Compliance 727 Fairview Drive, Suite E, Carson City, NV 89701.
      • Workers' compensation for each personal assistant, Commercial liability in an amount not less than $2M in general and not less than $1M per claim, Insurance coverage for employee dishonesty for not less than $25K per claim.
    •  Surety bond
      • Must be indebted to the State of Nevada, Department of Human Services, Aging and Disability Services.
      • Must list the facility's doing business as (DBA) name and physical address of the facility listed on the top.
      • Must have the full physical address of the facility on the bottom right.
      • Must be signed by the principal/owner.
      • Must be original seal/stamp on the surety bond from the bond company.
      • Per NRS 449.065, the bond must be $5,000 if you have fewer than 7 employees, $25,000 for 7-24 employees, $50,000 for more than 25 employees. 
    •  Copy of (Local - City or County) Business License, Conditional Use Verification Form, Zoning Approval Letter, or Special Use Permit from the local, city or county Jurisdiction.
      • Payment receipts do not meet this requirement and will not be accepted.
      • The local license must list your Doing Business As (DBA) facility name and physical location of the facility.      
    •  High School Diploma or Equivalent for Administrator
      • A United States high school diploma or equivalent (like a GED).
      • Must go through NACES if a foreign diploma.
    •  Proof that Administrator is 18 Years Old
      • Government-issued Identification: Documents like driver's licenses or state ID cards can serve as proof of age.
    •  Copy of Social Security Card
    •  Proof that Applicant has attained the age of 21 Years Old
      • Government-issued Identification: Documents like driver's licenses or state ID cards can serve as proof of age.
    •  3 Professional reference letters for the applicant 
      • Evidence (satisfactory to the Division) that the applicant is of reputable and responsible character.
      • A professional reference is typically a current or former employer, colleague, client, vendor, supervisor, or someone else who has first-hand knowledge and can recommend you for employment.
      • If the applicant is a firm, association, organization, partnership, business trust, corporation or company, similar evidence must be submitted as to the members thereof, and the person in charge of the intermediary service organization for which application is made.
    •  Statement regarding obligation of child support
      • Please contact the Division of Welfare and Supportive Services directly regarding this form. You can find their contact information at  https://dwss.nv.gov/