Finding and Building Out a Physical Space

What it is: Zoning, ADA, or construction — this is the most genuinely new work in opening a physical site.

Why it matters: Get the space or zoning wrong and you can lose months (or your lease deposit) discovering — after signing — that your city won’t allow a clinic there, or that you need far more construction than expected to meet code.

Step 1: Size it right. A typical center-based ABA clinic runs 4,000-6,000 sq ft, with roughly 35-50 sq ft of clinical space per child. Individual therapy rooms are usually small and sound-dampened.

Step 2: Lease, don’t buy, your first site. Only consider buying if you’ll stay 10+ years — owning adds more overhead on top of a mortgage payment once you count taxes, insurance, and maintenance.

Step 3: Check zoning before you sign anything. Zoning is the local rule about what kind of business is allowed at a given address — usually fine in commercial zones, often NOT allowed in residential zones without a special permit. This is genuinely city-specific: in one real example, a residential-zone ABA clinic in Dallas needed a Specific Use Permit adding 60-90 days, while neighboring cities in the same metro handled it differently. Call the local planning department yourself or confirm with the landlord or the real estate agent.

Step 4: Build to ADA standards. Accessible pathways need at least 36 inches of clear width (32 at doorways); accessible restrooms need a 60-inch turning radius.

Step 5: Design for sensory needs. Dimmable warm lighting, acoustic panels, muted colors, closed storage. Many clinics include a dedicated sensory room.

Step 6: Pass fire and health inspections, and get your Certificate of Occupancy. Required whenever you change a space’s use (e.g., retail → therapy space). Typically takes few weeks once construction is done.

Step 7: Get signage approved twice — landlord sign-off and a separate city permit.

TIP: Start payer location enrollment (“Enrolling a New Physical Location With Payers”) the moment you have a signed lease with a firm address — don’t wait for construction to finish.

WARNING: Don’t sign a lease before confirming zoning.