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A circular blue-and-white logo appears next to the text “Delaware County Board of Developmental Disabilities.”
  • Levy
  • About
    • Mission, Vision, and Values
    • Strategic Plan
    • History
    • The Board
      • Board Meetings
      • Board Officers and Appointments
    • Get Started
    • Leadership Team
    • News & Events
    • Annual Block Party
    • Annual Impact Report
  • Individuals & Families
    • Intake & Eligibility
    • Birth Through Age 2 (Early Intervention)
    • Ages 3 Through Adulthood
      • Family Support Services
      • Service & Support Administration
    • Finding A Provider
    • Report an MUI
  • Providers
    • Becoming a Provider
    • Free Choice of Provider Portal – Waiver Funding
    • Provider Resources
    • Report an MUI
  • Resources
    • Tools & Resources
    • MUI/UI Information
    • Grants
      • Accessibility and Inclusion Grant
      • Advocacy Grant
      • ARPA Grant 2024
    • Blue Envelope Program
    • iBill Money Identifier Program
    • Universal Changing Table Lending Program
    • Waivers & Medicaid
    • Complaint Process
    • Notice of Privacy Practices
    • Records
    • Accessibility Statement
  • Newsletters
    • Perspectives
    • Provider Connections
    • Subscribe to DCBDD Newsletters
  • Contact
    • Contact Us
    • Career Opportunities
    • Outstanding Provider Recognition
    • Speaker/Training Request
  • Levy
  • About
    • Mission, Vision, and Values
    • Strategic Plan
    • History
    • The Board
      • Board Meetings
      • Board Officers and Appointments
    • Get Started
    • Leadership Team
    • News & Events
    • Annual Block Party
    • Annual Impact Report
  • Individuals & Families
    • Intake & Eligibility
    • Birth Through Age 2 (Early Intervention)
    • Ages 3 Through Adulthood
      • Family Support Services
      • Service & Support Administration
    • Finding A Provider
    • Report an MUI
  • Providers
    • Becoming a Provider
    • Free Choice of Provider Portal – Waiver Funding
    • Provider Resources
    • Report an MUI
  • Resources
    • Tools & Resources
    • MUI/UI Information
    • Grants
      • Accessibility and Inclusion Grant
      • Advocacy Grant
      • ARPA Grant 2024
    • Blue Envelope Program
    • iBill Money Identifier Program
    • Universal Changing Table Lending Program
    • Waivers & Medicaid
    • Complaint Process
    • Notice of Privacy Practices
    • Records
    • Accessibility Statement
  • Newsletters
    • Perspectives
    • Provider Connections
    • Subscribe to DCBDD Newsletters
  • Contact
    • Contact Us
    • Career Opportunities
    • Outstanding Provider Recognition
    • Speaker/Training Request

Provider Certification Application Checklist

Ohio Department of Developmental Disabilities Certification Application Checklist

Homemaker/Personal Care, Shared Living, Informal Respite (non-family members), Residential Respite, Participant Directed Homemaker/Personal Care, and Transportation.

  • If you are becoming a provider for someone for whom you are also a court-appointed guardian, you must obtain approval from the probate court prior to the services being authorized. Apply for Approval of Direct Services through the Delaware County Probate Court.
  • Birth certificate
  • Social Security card
  • Government-issued photo ID (proof of Ohio residency will be required if the address on your government-issued ID is not current)
  • High school diploma or GED, high school transcript showing graduation date, college degree or transcript
  • W9 form
  • First Aid training certificate (American Red Cross or equivalent training, must include in-person skills assessment)
  • Initial Training for Independent Providers training certificate (also listed on the application as “MUI” training and “Client Rights” training. DODD MyLearning website)
  • Electronic Visit Verification training certificate (Sandata Learn website, not required for shared living)
  • Email confirmation of Payee number (this will be listed on the application as “OSS verification of payee ID number)
  • Driver’s Abstract, only if you are applying for transportation certification (must be submitted within 14 days, may be obtained by your local BMV office)
  • Auto Insurance, only if you are applying for transportation certification (must be current and have your name listed)
  • $125.00 application fee, if application (fee may be waived depending on your services and application type. Fees are paid online at the time of application via credit card or electronic check)

Informal Respite (family member)

  • Birth certificate
  • Social Security card
  • Government-issued photo ID (proof of Ohio residency will be required if the address on your government-issued ID is not current)
  • High school diploma or GED
  • W9 form (print and sign from your online application)
  • Initial Training for Independent Providers training certificate (DODD MyLearning website)
  • Email confirmation of Payee number
  • $125.00 application fee, if application (fee may be waived depending on your services and application type. Fees are paid online at the time of application via credit card or electronic check)

REV 1.12.26

Head Office

  • 149 North Sandusky Street
    Delaware, OH 43015 

  • 740.201.3600 (local)
  • Contact Us

Resources

  • About Us
  • Individuals & Families
  • Providers
  • Tools & Resources
  • Accessibility Statement
  • DODD Intermediate Care Facilities Search
  • DODD Residential Options Counseling Pamphlet
  • About Us
  • Individuals & Families
  • Providers
  • Tools & Resources
  • Accessibility Statement
  • DODD Intermediate Care Facilities Search
  • DODD Residential Options Counseling Pamphlet

Quick Links

  • 740.201.3600
    Major Unusual Incidents
  • MUI@dcbdd.org
  • Perspectives Newsletter
  • Provider Connections Newsletter
  • Employee Email Log-in

Search

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