OSHPD 1 to 5 in plain English: who reviews your project

If you're opening a clinic or doing work inside a hospital in California, at some point someone's going to ask you, "Is this OSHPD 3?" It sounds like paperwork. It isn't. That one label decides who reviews your plans, who issues your permit and who inspects the work. So it's worth knowing which one you are before you spend money on drawings.

Here's the whole thing on one page. Below it, we go through each one the way we'd explain it if you called us.

Quick note on the name. OSHPD was the Office of Statewide Health Planning and Development, the state office that came up with these labels. That office is now the Department of Health Care Access and Information, or HCAI. The labels kept the old name, so you'll still see "OSHPD 3" on drawings and in the code book. When we say HCAI below, we mean the state.

Why it matters who reviews your plans

On most buildings, your city or county does everything: plan check, permit, inspections. Healthcare works differently. For hospitals, psychiatric hospitals and nursing facilities, state law takes that job away from the local building department and gives it to HCAI. Most clinics stay with the city or county. So the first thing to figure out is which side of that line your project is on.

OSHPD 1 and 5: hospitals

OSHPD 1 is general acute care hospitals. OSHPD 5 is acute psychiatric hospitals. On both, HCAI reviews the plans, approves them and inspects the construction. The city isn't your building official here. The state is.

Two details are easy to miss. First, a hospital campus isn't automatically one class. Some buildings and parts of the site can be under HCAI and the rest under the city, so go building by building. Second, a hospital building that's taken out of acute care service can stay under HCAI anyway. You'll see those marked OSHPD 1R.

Hospital jobs also come with a dedicated inspector. All hospital construction has to be continuously inspected by a certified Inspector of Record, or IOR. The hospital provides the IOR, the architect or engineer in charge approves them, and HCAI signs off on them for each project before work starts. Their information, including a workload report dated within 30 days, goes in with the permit application.

This is why we keep a full-time inspector on staff with 25 years of experience with HCAI. When someone is watching every step, you want the work right the first time.

OSHPD 2: nursing facilities

Skilled nursing and intermediate care facilities are reviewed and inspected by HCAI too. Here's the catch: HCAI only uses OSHPD 2 for single-story buildings with wood or light steel framing (Type V construction). Work at any other skilled nursing facility is handled as OSHPD 1, the same as a hospital. If you run one, ask your architect which one you've got before anything gets drawn.

OSHPD 3: clinics, which is probably you

If you're a doctor or dentist opening a practice, this is the one you'll hear about. The key detail: the OSHPD 3 rules only apply to clinics and outpatient facilities licensed by the California Department of Public Health. So the real first question is whether your practice needs that license. Your architect can tell you which way your project goes. The clinic rules themselves are in Section 1226 of the 2025 California Building Code.

Even when OSHPD 3 applies, it's usually not the state reviewing you. For most clinic projects, your city or county building department enforces the OSHPD 3 rules: plan check, permit, inspections and the certificate of occupancy. In the City of Los Angeles, that's the Department of Building and Safety. In unincorporated areas and the cities that contract with the county, it's LA County Public Works Building and Safety. Anywhere else, start with the city's own building department.

There are a few exceptions. HCAI can get involved in plan review for surgical clinics, chronic dialysis clinics and outpatient buildings that belong to a hospital. Primary care clinics, birthing centers and rehab clinics stay with your local department. And if a hospital puts a freestanding outpatient building under HCAI, it stays there, remodels and all, until the owner asks HCAI in writing to hand it back.

One more thing to ask about early. When you apply for your clinic license, Public Health wants proof the building passed. For a licensed clinic, that certification comes from your local building department, either as a statement on the certificate of occupancy or on a Form 270. Bring it up at the start so it isn't the last thing standing between you and opening day.

OSHPD 4: correctional treatment centers

You probably won't build one of these, but for the full set: OSHPD 4 is correctional treatment centers. HCAI writes the building standards for them, but when the plans come from the state corrections department or a city or county law enforcement agency, that agency certifies its own plans and construction to HCAI instead of going through HCAI review.

What we'd tell you before you sign a lease

Figure out your class before you sign anything or pay for drawings. If you're a licensed clinic, you're probably OSHPD 3 and your city or county is reviewing it. If you're inside a hospital or a nursing facility, plan on HCAI. That's the kind of thing we sort out in preconstruction, before the schedule depends on it.

A couple of other things to keep in mind. HCAI approval isn't a license: HCAI reviews plans and inspects construction, but it doesn't decide whether Public Health accepts the building for licensed use. And planning, zoning and the fire department still get their say, even when HCAI is the building official.

Codes get updated too. HCAI lists the 2025 California Building Standards Code as current, so make sure your architect is drawing to that edition.

Not sure which one you are?

Call us. We're a Los Angeles general contractor focused on healthcare. Send us the address and your floor plan, and we'll tell you which class we think you're in and who's likely to review it, before you spend money on drawings. Start here, call (562) 652-3698 or email build@lahd.co.

Where this comes from

• HCAI Code Application Notice 2-0, OSHPD jurisdiction
• HCAI Advisory Guide A17, OSHPD 3 clinics
• HCAI forms, applications and reminder lists
• HCAI codes and regulations
• HCAI building permits and construction observation
• HCAI inspector information for owners and designers
• City of Los Angeles Department of Building and Safety
• LA County Public Works Building and Safety

We checked these on November 6, 2026. This is general information, not legal or code advice. Your architect, engineer and the agency reviewing your project have the final say.