Emergency Health Services

Certification and Inspections

Ambulance Operator Certification

All air and land ambulance services must be certified by the ministry to operate in the province.

To be considered for certification by the ministry as an air ambulance operator, an agreement with Ornge to operate an air ambulance service and to receive Ornge base hospital program services is required. Please contact Ornge for further information.

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How to be Certified to Operate an Ambulance Service

To be certified to operate an ambulance service in Ontario, you must complete and submit an application form and associated fee by certified cheque or money order payable to the Minister of Finance in the amount of $40.00.

Applications must be submitted at least 120 days before the ambulance service is intended to begin.

Requests for an application form and completed forms (along with the associated fee) can be sent to:

Inspections & Certifications
Emergency Health Regulatory and Accountability Branch
590 Rossland Road East
Whitby ON L1N 9G5

Attention: Chair, New Operator Certification Panel
Telephone: 905-665-8086

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New Operator Certification Package

Once the application and fee are received, a new operator certification package will be provided to the applicant, typically within seven business days. The package sets out the criteria and requirements an applicant will need to meet to demonstrate their readiness to be certified to provide land ambulance service in Ontario.

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New Operator Process and Certification

Next, an applicant will need to submit documentation that outlines how the applicant intends to fulfill the legislated requirements as set out in the certification package. Once the applicant has submitted the required documentation, the ministry will convene a new operator panel with representatives from the ministry and ambulance services to finalize the process.

When the applicant has successfully completed this process, the new operator panel will recommend the operator to the certifying authority for certification as an ambulance service operator for a term of one year. They will then receive a certificate to operate an ambulance service in Ontario.

Within 180 days of receiving a certificate to operate an ambulance service, the operator must undergo an Ambulance Service Review. Successful completion of the Ambulance Service Review will typically result in a three-year certificate to operate.

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Certified ambulance service operators must undergo a ministry-led peer recertification process every three years – before their existing certificate has expired. This process confirms that the operator meets compliance with legislated land or air certification standards as applicable. The certification of a service is not extendable under the Ambulance Act.

Notice of an upcoming Ambulance Service Review is given 90 days before the on-site review occurs. Notification includes a team checklist self-assessment and resource tool, which helps an ambulance service prepare for the on-site review.

Ambulance service providers will also be sent a letter to confirm the date and time of their review, approximately 30 days before the on-site visit.

When a service has successfully completed the ambulance service review, demonstrating compliance with the land or air ambulance certification standards, the service is issued a three-year certificate to operate an ambulance service. When an ambulance service does not initially meet certification standards, the ministry conducts a supplemental visit to re-evaluate the service’s success in meeting the standards.

The Ambulance Service Review team includes representation from about 70 percent of Ontario’s paramedic services. The on-site team includes one ministry team leader, Service Chiefs, Deputy Chiefs, Commanders, Deputy Commanders, Superintendents – as well as Primary, Advanced and Critical Care Paramedics. Team members are considered subject experts in their field, working together to ensure excellence in ambulance services for all Ontarians.

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Certifying Ambulance Models

In addition to certifying ambulance service operators, the Emergency Health Services Division also certifies various types of ambulance models built by manufacturers.

Every new and remounted ambulance intended to be used in Ontario must be certified by the ministry before it can be placed in service.

To obtain certification for an ambulance model produced by a manufacturer, it must be in full compliance with the Ontario Provincial Land Ambulance and Emergency Response Vehicle Standard that is current at the time of its delivery.

The process for certification of an ambulance model may include a review of testing documentation for the specific model. It could also include on-site visits to the manufacturer’s production or testing facilities at times when manufacturing and/or performance standard testing of ambulances intended for use in Ontario is occurring.

To help schedule certification of new ambulance models, the manufacturer shall provide the director with a minimum of 60 calendar days notice before commencing testing of a new ambulance model.

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Emergency Response Vehicles

For every emergency response vehicle (ERV), the operator either directly through a contractor, or indirectly through a third party, shall ensure that all necessary compliance testing is undertaken and completed. The ministry does not currently issue compliance certification for ERVs.

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Inspectors visit air and land ambulance service operators, ambulance communication services, and base hospitals to ensure they are complying with current legislation, regulations and standards under the Ambulance Act. Inspections can be scheduled or unscheduled, in-depth or of specific focus. Inspectors also have authority under legislation to visit an ambulance service at any time.

Types of Inspections

  1. Ambulance Service Reviews

    Air and land ambulance services must have an Ambulance Service Review every three years. An ambulance service review is a ministry-led peer recertification process that must take place before an existing certificate expires. It confirms that an ambulance service operator meets legislated land or air certification standards.

    The Ambulance Service Review team uses several activities and processes to evaluate whether a service provider is meeting the requirements of the legislation and standards. The team may utilize methods such as interviews with service staff, documentation review, ride-outs, observations and examinations of vehicles and equipment.

  2. Follow-Up Inspections

    After an ambulance service has been found to meet its certification standards, follow-up inspections take place. They confirm that the ambulance service has completed any actions required to address observations noted during the Ambulance Service Review.

  3. Ambulance Communication Services and Base Hospital Reviews

    Ambulance communication services and base hospital programs undergo a Quality Assurance Review every three years to ensure they are complying with their performance agreements and legislation.

    The review team uses several activities and processes to evaluate whether they are meeting the requirements of their performance agreement, legislation and standards. These review activities could include interviews with service staff, a documentation review, evaluating live and taped calls – as well as reviews and inspections of vehicles and communication equipment.

  4. Service Review Supplemental Visits

    Supplemental visits take place if an air and land ambulance service, ambulance communication service, or base hospital did not meet certification standards during its review.

  5. Unannounced Inspections

    Unannounced inspections of air and land ambulance services, ambulance communication services, or base hospitals take place without prior notice. They are conducted throughout the service’s three-year certificate period.

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For More Information

Emergency Health Services
5700 Yonge Street, 6th Floor
Toronto, Ontario
Canada   M2M 4K5

Tel: 1-800-461-6431 (Toll-free in Ontario only)
In Toronto: (416) 327-7900
Fax: 416-327-7911
Email: websitecontact.moh@ontario.ca


Call ServiceOntario, Infoline at:
1-866-532-3161 (Toll-free in Ontario only)
TTY 1-800-387-5559.
In Toronto, TTY 416-327-4282
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