Texas Child Care Licensing Requirements for RTCs
A plain-English overview of the Texas HHSC Child Care Licensing requirements that govern Residential Treatment Centers and General Residential Operations. Everything below is grounded in 26 TAC Chapter 748 — the official minimum standards.
Governing body
Every operation must have a defined governing body — board, owner-operator, or LLC manager — with documented authority over policy, finances, and the LCCA. The governing body is HHSC's accountable counterparty.
Administrator (LCCA)
Every operation must list a Licensed Child Care Administrator. The LCCA is personally responsible for daily compliance with Chapter 748 and is the operation's primary point of contact with CCL.
Personnel
Required: background checks, pre-service training, annual training hours, documented job descriptions, performance reviews, and personnel files compliant with Chapter 748 Subchapter D.
Child rights and behavior intervention
Operations must publish a child-rights statement and an emergency behavior intervention (EBI) policy. Physical restraint is heavily regulated and requires documented training and reporting.
Medication and medical care
Medication administration requires written policies, trained staff, secure storage, documentation logs, and protocols for errors and missed doses.
Education
Each child in care must have an education plan — on-site school, ISD enrollment, or an approved alternative — with documented transportation, attendance, and academic progress.
Facility, health, and fire
Facility requirements include zoning and Certificate of Occupancy, fire and life safety, ADA accessibility, minimum bedroom and bathroom space, secure storage, kitchen sanitation, outdoor recreation, and approved fire and health inspection letters.
Records and reporting
Every operation must maintain child records, incident reports, staff records, and serious-incident notifications to CCL within required timeframes.
Frequently asked questions
Who regulates Residential Treatment Centers in Texas?
The Texas Health and Human Services Commission (HHSC) Child Care Licensing (CCL) division regulates all 24-hour residential child care operations, including RTCs and GROs. The governing rules are 26 TAC Chapter 748.
What is Chapter 748?
Chapter 748 of the Texas Administrative Code is the minimum standards rulebook for General Residential Operations. It covers governing body, administrator, personnel, child rights, behavior intervention, medication, education, health, fire/safety, facility, and record-keeping requirements.
What documents does HHSC require to apply?
At minimum: Form 2710 (application), governing body documentation, designated LCCA, background-check authorizations for staff and household members, a complete operational plan, treatment program description, facility floor plan, fire/health inspection letters, and the application fee.
What facility requirements apply to a Texas RTC?
Facility requirements cover zoning and Certificate of Occupancy, fire and life safety, sprinkler/alarm coverage, ADA accessibility, minimum bedroom square footage per child, bathroom ratios, kitchen and laundry sanitation, outdoor space, and secure storage for medications and records.
Are there staffing ratios for an RTC?
Yes. Chapter 748 sets minimum child-to-caregiver ratios that vary by age group, awake-night supervision requirements, and minimum pre-service and annual training hours. Programs serving higher-acuity youth typically staff well above the minimums.
How often does HHSC inspect an RTC?
After the pre-opening inspection and Certificate of Compliance, RTCs receive routine annual inspections plus unannounced inspections in response to complaints, serious incidents, or trends in your monitoring history.