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Service Provider Forms

All Service Providers

Nursing Level Respite Providers

Vendor Applications

Become a Service Provider

Become a Service Provider

If you are interested in becoming a provider for the California regional centers you must complete an application and complete a process referred to as “vendorization”. Service providers are vendored by the regional center in whose region (known as catchment area) the service is located, and that regional center is known as the “vendoring regional center.” The vendoring regional center is responsible for ensuring that the applicant meets the licensing and Title 17 requirements for vendorization, determining the appropriate vendor category for the service, and authorizing or not authorizing vendorization based upon review of the documentation submitted by the applicant.

The vendorization process is for identification, selection, and utilization of service providers based on their qualifications and other requirements. This process allows regional centers to verify, prior to the provision of services to clients, that the applicant meets all the requirements and standards specified in the regulations. Applicants who meet the specified requirements and standards are assigned a service code and a unique vendor identification number. Although a regional center must vendor an applicant who meets all the requirements for the service to be provided, vendorization in no way obligates a regional center to make referrals to or purchase services from that vendor.

Prospective service providers should contact the San Diego Regional Center (SDRC) Community Services Department prior to filing an application to discuss the proposed service and process. (See below for contact information). Once the application is submitted with the required forms, licenses and certificates, SDRC has 45 days from receipt of the application to determine whether the applicant meets the requirements of Title 17.

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Please review the DDS Guidelines for Vendorization and Rates Frequently Asked Questions.

For information regarding services, becoming a provider and/or a vendor application, please contact the appropriate Resource Coordinator.

SDRC Community Services

For information regarding services, becoming a provider and/or a vendor application, please contact the appropriate Resource Coordinator

Robert Webb-Rex

Resource Coordinator

Residential Services
Community Care Facilities
Foster Family Agencies
Health Care Facilities

Linda Livingston

Resource Coordinator

Independent Living Agencies
Supported Living Agencies

Paul Quinones

Wenddy Baca

Resource Coordinators

Employment Services
Day Programs
Paid Internship Program

Sandra Bishop

Resource Coordinator

In-Home Respite Agencies
Day Care
FHA Homes
Home Health Agencies

Erik Peterson

Resource Coordinator; Development Manager

Community Placement Plan Projects
Negotiated Rate Facilities
Requests for Proposals (RFP)

Resource Coordinator

Community Placement Plan (CPP) Development and Resources
Southern California Integrated Health & Living Project

Rosalie Goulding

Resource Coordinator

Behavior Specialists
Early Start
Other Specialists
Day Activity Programs

Evaluation Specialist

Quality Assurance Specialist

Jorge Malone

Transportation Coordinator

Transportation Services

Patent Preparation and Prosecution

Breach Incident Report

If information about an individual a vendor serves is ever lost, stolen or received by anyone who is not that person or that persons legally authorize representative, the California Department of Developmental Services (DDS) considers that a “security breach.” Anytime there is a security breach of information possessed by a vendor, DDS requires the vendor to both notify the person whose information was breached (or their legally authorized representative) by letter, as well as the Regional Center using form DS 5340B. The letter sent to the individual needs to be sent within 60 days of the discovery of the breach and a copy needs to be sent to the Regional Center. Vendor breaches also need to be reported to the U.S. Department of Health and Human Services (HHS) Office of Civil Rights (OCR) online here

If you have any questions, please contact Seth Mader, San Diego Regional Center’s Information Security Officer.

Service Provider Forms: Breach
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