1. How to Open an Adult Daycare Facility

     Adult daycares are facilities that disabled adults or seniors attend during the week while their caregivers are working or otherwise engaged. The daycares provide a stable environment for seniors or disabled adults to participate in activities. Activities can include community based activities, therapy sessions, in house recreational activities such as games, cooking and crafts. Participating in social and community activities allows seniors and disabled adults to keep engaged in life, to make and maintain friendships with peers.

     Choose a Location for the Adult Daycare

     Find a suitable location for your adult daycare service. The location should have handicapped accessible bathrooms and easy to reach facilities.

     Measure the hallways and ensure the hallways are wide enough so that wheelchairs and walkers can maneuver around in them.

     Walk through the building and examine it. An adult daycare facility needs large areas available for recreation activities and a well designed commercial kitchen. The parking lot should have plenty of parking spaces including large handicapped accessible wheelchair van spaces. A wide wheelchair ramp at the entrance of the building will allow individuals to enter the building.

     Assess the smoke detectors and the fire safety of the building. The smoke detectors must be interconnected, and most states prefer a sprinkler system when you have an Adult Day Care facility.

     Obtain Adult Day Care State Certification and Licensing

     Fill out an adult daycare license application for the state you plan to open an adult daycare in. Licensing involves filling out a state licensing application (See Resource 2 for a sample.) and attaching all required documentation to the application.

     Include the following in your application; the name of the center, address and contact information of the person filling out the form, and the name of the owner of the center. Identify all services that your daycare will provide and the planned staff to individual ratio.

     Fill out a certification application if your state requires that your adult daycare become certified. Some states do not require state certification, while others do.

     Document and include information for the state to examine. Fire safety packets that describe fire drill protocols. Staff training and the dates that the training occurred. Staff vehicle insurance if the staff drives individuals to community activities. Types of medications the staff must administer and the name of the nurse supervisor.

     Contact the state to set an appointment with the State’s Certification and Licensing department. Expect them to walk through the facility to ensure the facility is up to code, and they will also review all the facility’s paperwork to make sure that it meets state standards. They will notify you if you have any areas that you need to work on and also report if you meet certification and licensing standards to the state.

     Establish Rates, Payroll and Connect with Insurances for Billing Purposes

     Decide the daily rates each person will pay while attending the facility. Factor in individual attention, services rendered to the individual, types of activities the daycare will offer and the cost to run the facility, including staffing costs.

     Contact Medicaid, Medicare and other insurances and set up a billing system with them. Hire an accountant to cover all accounting issues.

    Hire a Human Resource coordinator to work with the accountant regarding payroll and to oversee also staff development.

    Hire Staff

    Perform background checks and driver license checks on all staff. Staff members who work with adults that attend the daycare need to have a clean background and a clear driving record.

    Train staff before they start working. Teach the staff how to document daily activities. Enroll the staff in any trainings that they need to attend before the daycare opens. Staff should receive training on how to give medications in accordance to state regulations. Staff members should know how to properly document any medications they administer at the facility.

    Work on completing all the training before the adult daycare opens. Adult daycare staff training should include the following; lifting techniques, documentation training, blood born pathogens, first aid and cardiopulmonary resuscitation, HIPPA training, state medication certificate, wheelchair van training, and OSHA training. State training regulations will vary from state to state.

    Extra Tips for opening an adult daycare facility

    •  Get business insurance to cover any liability costs for the facility.
    • Write a business plan and apply for federal and local grants. Hire a grant writer to assist you with the process.

    • Contact the fire and safety inspector and have them inspect the building to ensure it will make a good facility.

    • Contact the state you wish to open the adult daycare facility in and check regulations for adult daycares. Regulations for adult daycares vary across the country.

     Certification Tips

    • Once your adult daycare center is open the state will also require copies of all day program documentation regarding client activities and services.

    • The state will also review all medication books for possible medication administration errors.


    National Adult Day Services Association: About Adult Day Cares


     U.S. Department of Health and Human Services: Regulatory Review of Adult Day Services: Final Report Licensing Certification and Other Requirements


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