How does a clinic get inspected, licensed or accredited in Ontario, BC or Quebec?
It depends on the province and on the procedures you perform. An Ontario out-of-hospital premises is inspected by the CPSO within 180 days of its application, a BC facility needs CPSBC provisional accreditation before it opens, and a Quebec specialized medical centre needs a Santé Québec authorization and accreditation within three years.
Four routes, by province and procedure
The CPSO inspects every premises outside a hospital where physicians perform procedures under general anesthesia, parenteral sedation or regional anesthesia other than a digital nerve block, and certain cosmetic and chronic pain procedures under local anesthesia. A New Premises Inspection Application carries a $500 fee.1 Ontario's community surgical and diagnostic centres are licensed by the Ministry of Health and inspected by Accreditation Canada.2 In British Columbia, a facility must hold provisional or full accreditation to provide a procedure in Schedule G of the CPSBC Bylaws.3
| Route | Who decides | First step | Then |
|---|---|---|---|
| Ontario out-of-hospital premises | CPSO | New Premises Inspection Application, $500 | Inspection within 180 days, then every 4 years |
| Ontario community surgical or diagnostic centre | Ministry of Health, with Accreditation Canada | A call for applications, then a pre-licensing inspection | A full inspection within six months of opening, then every 4 years |
| BC non-hospital facility | CPSBC NHMSFAP Committee | Provisional Accreditation Application, C$3,000 | An assessment before opening, a patient tracer in the first year, then every 46 to 48 months |
| Quebec specialized medical centre | Santé Québec | An application for a CMS authorization | Accreditation within 3 years, and renewal every 5 years |
What each body checks before you treat patients
A new Ontario centre passes a pre-licensing inspection against selected ICHSC requirements, with 5 days to correct what it finds, and is not considered accredited until its first full Accreditation Canada inspection.2 A new BC facility is assessed against CSA Z8000 standards, facility management, patient experience, building services, emergency preparedness, infection prevention and control, and safety and risk, and must remediate every nonconformance before it opens.3 The application form asks for the owners, the medical director, the specialties and the anesthesia level.4
In Quebec, the Santé Québec authorization names the place of operation, the physicians' participation status, the specialized medical treatments, the number of operating rooms and any beds, up to 10. Only a physician who is a member of the Collège des médecins du Québec, or a company more than half held by such physicians, may hold one.5 Within three years the centre must have its services accredited by a body Santé Québec recognises, and keep that accreditation at all times.6
- Name your procedures and anesthesia. They decide which body you answer to, and in BC which class of accreditation you need.
- Appoint a medical director. The CPSO and the CPSBC both hold the medical director accountable. A Quebec CMS appoints a medical and professional services director from its physicians.
- Apply to the right body. The CPSO New Premises Inspection Application, the CPSBC Provisional Accreditation Application with its fee, or the Santé Québec CMS form.
- Write the policy and procedure manual. Cover every area the body lists, and have each person read it before they start.
- Set up the record system. Booking, consent, signed notes and an audit trail from the first patient, so the first inspection reads real records.
- Pass the first visit. Fix every finding inside the deadline you are given, with evidence.
- Diarise the cycle. Every 4 years in Ontario, every 46 to 48 months in BC, and the Quebec accreditation and renewal dates.
- Province ______ Body ______
- Procedures ______ Anesthesia or sedation level ______
- Medical director ______ Appointed on ______
- Application sent on ______ Fee paid ______
- Policy manual approved on ______
- First inspection or assessment on ______
- Findings closed on ______ Next cycle due ______
Questions
Does every Ontario clinic need a CPSO inspection?
No. It applies to premises where physicians perform procedures under general, regional or parenteral anesthesia or sedation, or certain cosmetic and chronic pain procedures under local anesthesia.
Can a new BC facility open on provisional accreditation?
Yes, once the opening assessment finds no nonconformance left open. A patient tracer assessment follows within the first year.
How long does a Quebec CMS authorization last?
Five years, renewable. The centre must also be accredited within three years and keep that accreditation.
Sources
- 1College of Physicians and Surgeons of Ontario, 2026Out-of-Hospital Premises Inspection ProgramRead source
- 2Accreditation Canada, 2026ICHSC Quality Assurance Program Information, version 2.5Read source
- 3College of Physicians and Surgeons of British Columbia, 2026NHMSFAP Accreditation Manual, version 1.2, effective 1 April 2026Read source
- 4College of Physicians and Surgeons of British Columbia, 2026Provisional Accreditation Application, non-hospital medical and surgical facilityRead source
- 5LégisQuébec, Gouvernement du Québec, 2026Act respecting the governance of the health and social services system, chapter G-1.021, updated to 12 August 2026Read source
- 6Santé Québec, Gouvernement du Québec, 2026Formulaire de demande de renouvellement et modifications d’une autorisation CMSRead source
Written by the wai team from Accreditation Canada, the CPSO, the CPSBC and Santé Québec guidance, checked on 16 October 2026. This is guidance, not legal advice. Neither Accreditation Canada, the CPSO, the CPSBC nor Santé Québec endorses wai or any software.