SC CRCF licensing: Application and physical plant standards

Licensing is mandatory before operation: No person or organization may open, run, or advertise a CRCF in South Carolina without first obtaining a DPH license — a facility cannot admit a single resident before that license takes effect. This applies regardless of what the facility calls itself ("assisted living," "residential care," etc.) — the legal trigger is the function (the regulation's definition, § 101.L, covers providing or coordinating personal care for more than 24 consecutive hours for two or more people 18 or older who are not related to the licensee), not the marketing name.

Physical plant and safety specifics (section numbers are from R.61-84 as published online; the text we reviewed may lag the official State Register):

Item	Requirement	Section
Toilets	At least one toilet for each six licensed beds or fraction thereof	2604.B
Handwash lavatories	At least one adjacent to each toilet	2604.C
Bathtubs or showers	One for each eight licensed beds or fraction thereof	2604.D
Hot water	Resident-accessible fixtures that need hot water are thermostatically controlled to at least 100°F and not more than 120°F at the fixture	2301.B
Building codes	Comply with the codes adopted by the South Carolina Building Codes Council	1601
Fire protection	Fire protection and suppression systems maintained and tested as required	1502
Emergency plan	A suitable written plan for disaster and emergency evacuation	1401.A
Posted evacuation plan	Evacuation routes and procedures for fire and other emergencies posted	1503.B
Fire drills	Designed so residents practice exiting through all exits	1504.D

Administrator requirement: The facility administrator must be licensed as a CRCF administrator under S.C. Code § 44-7-260 (§ 502.A).

If you're evaluating a physical space for a new CRCF or expanding an existing one, check the bathroom fixture ratios and hot water controls early — these are common, expensive-to-fix-late findings during initial licensing inspection.