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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.

Become a Service Provider Today!

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

Miguel Larios

Community Services Director

Robert Webb

Resource Manager

Erik Peterson

Resource Development Manager

Resource Coordinator

 Family Home Agencies (FHA)

Resource Coordinator

Day Programs

Like-a-like Day Programs

Tailored Day

Resource Coordinator

 Residential Facilities

Intermediate Care Facilities (ICF)

Resource Coordinator

 Social Recreation


Resource Coordinator

Supported Living (SLS)

Independent Living (ILS)

Coordinated Family Supports (CFS)

Personal Assistance (PA)

Resource Coordinator





Resource Coordinator

Early Start & Clinical

Resource Coordinator

Employment Services

Paid Internship Program

Resource Coordinator

Self Determination


Participant Directed Services



Resource Coordinator

 CRDP Housing

Resource Coordinator

 CRDP Housing

Resource Coordinator

Housing Navigator

Todd Lordson

Transportation Coordinator

Transportation Services

Jorge Malone

Transportation Assistant

Transportation Services

Juan Gonzalez

Health & Safety Waiver Specialist


HCBS Specialist

Tiffany Swan

Emergency Management Coordinator

Kristen Van Den Broek

Quality Assurance

Sarah Pierce

Quality Assurance

Albert Noriega

Rate Specialist

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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