Published 12 September 2026 · By Jatin Dua, Broker of Record, RE/MAX Quantum Realty
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Get My Free Estimate →There is no physiotherapy clinic licence in Ontario. No premises accreditation. No facility inspection. The College of Physiotherapists’ own Opening a Practice Checklist covers College notification, incorporation, insurance, records, accessibility and patient safety — and contains no clinic licence and no premises approval step. There is nothing here equivalent to pharmacy accreditation or a dental facility permit. That sounds like good news and it is a trap, because it means nobody inspects the room before you open. Your real premises constraints are the landlord’s lease, the Ontario Building Code, the zoning by-law, the accessibility rules, and the College’s Infection Control Standard, effective 1 February 2025, which you are expected to meet without anyone checking first.
The finding that shapes everything: there is no regulator at the door
I went looking for the physiotherapy equivalent of a pharmacy’s Certificate of Accreditation or a dental office’s x-ray plan approval and sedation facility permit. It does not exist.
The College of Physiotherapists of Ontario publishes an Opening a Practice Checklist. It tells you to notify the College, to consider incorporation, to arrange professional liability insurance, to set up records, to comply with accessibility legislation and to consider patient safety in setting up the space. What it does not contain is a clinic licence application, a premises approval, or an inspection you have to pass before you see patients.
So for a buyer, the question “what permits come with the clinic?” has an unusual answer in this profession: on the premises side, essentially none. And that shifts the entire weight of your diligence onto two documents nobody in this sector reads carefully enough — the lease and the zoning confirmation — plus one standard that the College does expect you to meet.
The College tells buyers, in writing, to evaluate the existing space
This is the most useful sentence in the College’s checklist for anybody buying rather than building, and it is worth quoting exactly: “if you are purchasing an existing business, evaluate the existing setup of the clinic and make any improvements necessary to ensure patient safety.”
Alongside it, the same checklist directs you to “ensure your work space will be in compliance with the requirements of the Accessibility for Ontarians with Disabilities Act” and to “consider patient safety when setting up your work space or clinic.”
Note the framing. The College is not telling you to get the space approved. It is telling you to assess it and fix it. The obligation is yours and the judgement is yours, which is precisely why the assessment has to happen during your conditional period, when the price is still open, rather than in your first month, when it is not.
Practically that means walking the clinic with somebody who knows what the standard requires — a physiotherapist with infection control experience, or a consultant who does this work — and writing down what is missing. Then deciding whether the cost of fixing it belongs in your offer.
The Infection Control Standard came into force on 1 February 2025
This is the one published document that does impose physical expectations on a physiotherapy space, and it is recent enough that a clinic set up five years ago may never have been assessed against it.
The standard, effective 1 February 2025, requires a physiotherapist to ensure “all physiotherapy spaces and equipment are cleaned and disinfected prior to patient use.” It requires compliance with “current infection prevention and control best practices, including those in line with Public Health Ontario’s Provincial Infectious Diseases Advisory Committee (PIDAC) recommendations.” And it requires documented reprocessing of reusable critical and semi-critical equipment.
I want to be careful here, because this is where posts on this subject start inventing specifications. The standard does not publish a fixture schedule. It does not tell you how many sinks to install, what the reprocessing room must measure, or which flooring to buy. Anybody who quotes you a number from it is quoting something else.
What the standard implies about the room, without specifying it
What the standard does is set outcomes, and some outcomes cannot be delivered in some rooms. That is the honest way to translate it into a premises question.
If every space and every piece of equipment must be cleaned and disinfected before patient use, then surfaces have to be cleanable. Fabric-covered treatment tables, porous plinth surfaces, carpeted treatment areas and timber-topped benches are all harder to comply with than the alternatives, and replacing them is a cost. Ask what the treatment surfaces are made of.
If staff are performing hand hygiene and cleaning between patients, there has to be somewhere to do it. Count the sinks. Note where they are relative to the treatment areas, because a clinic with one sink in a washroom at the far end of a corridor is a different operational proposition from one with sinks in the treatment space.
If reusable critical or semi-critical equipment is being reprocessed on site and that reprocessing has to be documented, there has to be a place to do it and a place to store it clean. Ask whether the clinic reprocesses anything, what, where, and to see the documentation. If there is no reprocessing space and the practice depends on reusable instruments, you have found a fit-out item.
And read PIDAC. The College points at it explicitly, which makes Public Health Ontario’s best practice documents part of what you are being measured against even though they are not a building code.
| Who decides | What they control | What they do not |
|---|---|---|
| College of Physiotherapists of Ontario | Standards of practice, including the Infection Control Standard; certificate of authorization for the corporation | Does not licence, accredit or inspect clinic premises |
| Chief building official | Building permits, change of use, occupancy | Does not confirm zoning permission for you as a separate service |
| Municipal zoning | Whether the use is permitted at that address | Does not assess your clinical setup |
| Landlord, through the lease | Permitted use, alterations, restoration, assignment, parking | Owes you no duty to check your regulatory compliance |
| AODA / accessibility standards | Policies, training, service, and public spaces on new construction or redevelopment | Does not govern barrier-free design inside the building — that is the Building Code |
The Building Code is your real premises regulator
With no clinic licence in the picture, the Building Code does the work.
Section 10(1) of the Building Code Act, 1992 provides that “even though no construction is proposed, no person shall change the use of a building or part of a building or permit the use to be changed if the change would result in an increase in hazard, as determined in accordance with the building code, unless a permit has been issued by the chief building official.” The chief building official must issue the permit unless the proposed use would contravene the Act, the Code “or any other applicable law,” the application is incomplete, or fees are unpaid.
The City of Toronto states the rule more bluntly than the statute: “even if no construction is proposed, if a change of use is proposed a building permit is required.” Inside Toronto I would treat the City’s formulation as the operating rule and confirm the specific unit with the chief building official.
Why this matters on a clinic purchase: physiotherapy clinics routinely occupy units that started life as retail, as office, or as something else entirely. If the lawful use on record does not match what is happening in there, that is not the seller’s problem after closing. It is yours. And note the other half of the City’s page: “even if a building permit is not required, compliance with the Zoning Bylaw is required.” I build a building permit condition in where work is contemplated, for exactly this reason.
Zoning, and why the map is not the answer
Toronto’s city-wide Zoning By-law 569-2013 sets out permissions zone by zone. In the Commercial Local (CL) zone, for example, the uses permitted without conditions include medical office, massage therapy and wellness centre, among others. That looks encouraging until you read the structure of the by-law properly.
Three cautions, all from the City’s own material. Definitions live in Chapter 800, and the defined meaning of a use term controls — not the ordinary meaning, and not what you call your business on the sign. Site-specific exceptions live in Chapter 900 and can override the base zone. And two City-level warnings matter more than either: some properties remain subject to former municipal by-laws rather than 569-2013, and some provisions of 569-2013 are under appeal to the Ontario Land Tribunal and “are not in full force and effect.”
So never conclude a use is permitted on the strength of the interactive map. The City offers formal reviews, and that is what a buyer should be relying on. I handle this with a zoning condition so the confirmation arrives while the deal is still conditional.
The short version
Because there is no clinic licence and no premises inspection in physiotherapy, nothing external has ever verified that the space you are buying is lawful or compliant. Your diligence has to do that job. Read the lease first. Confirm the lawful use with the City rather than the listing. Walk the clinic against the Infection Control Standard that took effect on 1 February 2025, looking at surfaces, sinks and reprocessing space. Take the College at its word when it tells buyers to evaluate the existing setup and make the improvements patient safety requires — and price those improvements before your conditions come off.
Accessibility applies from your first employee
The accessibility rules apply to every business with at least one employee, so a two-person clinic is in scope. At one to nineteen employees you need accessibility policies, staff training on the Human Rights Code and accessible customer service, accessible employment practices, accessible information on request, and accessible public spaces for new construction and renovations — with no compliance report required. At twenty or more employees you must file an accessibility compliance report every three years, and the next deadline is 31 December 2026. Ontario’s own guidance notes that failing to file can attract enforcement measures including financial penalties.
The renovation trigger is worth understanding precisely. The Design of Public Spaces standards apply to public spaces “newly constructed or redeveloped,” and the Integrated Accessibility Standards Regulation defines “redeveloped” as “planned significant alterations to public spaces, but does not include maintenance activities, environmental mitigation or environmental restoration.” Repainting is maintenance. Reconfiguring the reception and waiting area is a planned significant alteration.
Within those standards, the service counter obligation is triggered “when constructing new service counters, which includes replacing existing service counters” — so swapping out the front desk engages it. The standards also cover exterior paths of travel, accessible off-street parking and waiting areas. Small organisations came into the compliance schedule on 1 January 2018. Barrier-free requirements for the building interior sit in the Building Code, not in the accessibility regulation, which is a point to raise with your designer early rather than late.
Parking is a clinical issue in this business
Physiotherapy patients are, by definition, often mobility-limited. Parking is not an amenity in this tenancy, it is part of the service.
Two separate questions. First, the zoning question: what parking the by-law requires for the use at that address, which is a City question and not a landlord question. Second, the lease question: what parking you actually have a contractual right to. Tenants routinely assume that the spaces outside their door are theirs and discover on reading the lease that they hold no exclusive rights at all, that the landlord can reconfigure the lot, or that designated spaces belong to another tenant. Accessible off-street parking also sits inside the Design of Public Spaces standards, so a redevelopment of the lot is not neutral. My note on parking clauses sets out what to look for.
What I put in a lease review condition for a clinic
Since the landlord is effectively your premises regulator here, the lease review is the diligence that matters most. Ontario’s Commercial Tenancies Act deems a covenant against assignment to include a proviso that consent will not be unreasonably withheld — but only “unless the lease contains an express provision to the contrary.” A lease can validly give the landlord absolute discretion. And a consent once given extends “only to the permission actually given,” so consenting to this assignment does not help you on your own exit.
The items I want read, with the actual document in hand: the permitted use clause, and whether it is drafted narrowly enough that adding a service breaches it; the assignment and change-of-control provisions; the alterations clause and the landlord’s approval process; the restoration obligation at the end of term, which is frequently the largest unpriced liability in a fit-out-heavy tenancy; parking rights; signage; hours of access; the operating cost and realty tax provisions; any relocation or demolition clause; and the remaining term and renewal rights measured against how long you need to recover the fit-out. The mechanics of the condition itself are in my note on the lease review condition.
One more thing. A lease review condition is only worth having if the period is long enough for your lawyer to actually receive the document, read it, and ask the landlord a question. A three-day condition on a lease the landlord has not yet produced is decoration.
How I sequence the premises review
Lease first, because it can end the conversation. Then the City, on lawful use and occupancy and zoning permission, rather than the listing or the map. Then the clinical walkthrough against the Infection Control Standard with someone who knows it: surfaces, sinks, reprocessing, storage. Then accessibility, and specifically whether anything you plan counts as redevelopment. Then decide what you are changing in year one, because that is what determines whether the Building Code, the accessibility standards and the landlord all join your transaction.
I am a broker. I do not certify infection control compliance and I do not give legal advice. What I do is make sure the room gets looked at properly while you still have the right to walk away from it.
Do I need a licence from the College to open or buy a physiotherapy clinic?
Not for the premises. There is no College clinic licence, no premises accreditation and no facility inspection for physiotherapy in Ontario. The College’s Opening a Practice Checklist covers College notification, incorporation, insurance, records, accessibility and patient safety, with no clinic licence or premises approval step. A professional corporation does need a certificate of authorization from the College in order to practise, renewed annually, but that attaches to the corporation rather than to the room.
If nobody inspects the space, does compliance still matter?
Yes, and more than usual. The absence of an inspection means no external party has ever confirmed the space is compliant or the use is lawful, so problems can sit undisturbed for years and transfer to you at closing. The College expects the standards to be met, the municipality expects the use to be lawful, and the landlord expects the lease to be honoured. All three can surface later, at a time you do not choose.
What does the Infection Control Standard require of the premises?
It sets outcomes rather than specifications. Effective 1 February 2025, it requires that all physiotherapy spaces and equipment are cleaned and disinfected prior to patient use, that practice complies with current infection prevention and control best practices including Public Health Ontario’s PIDAC recommendations, and that reprocessing of reusable critical and semi-critical equipment is documented. It does not publish a fixture schedule or minimum areas. The premises question is whether the room can deliver those outcomes.
How many sinks does a physiotherapy clinic need?
No published source states a number, and I will not invent one. What the Infection Control Standard requires is that spaces and equipment are cleaned and disinfected before patient use and that practice follows current infection prevention and control best practices in line with PIDAC recommendations. Whether the existing sinks let staff do that between patients is a practical judgement to make on a walkthrough with someone experienced in infection control, not a number to look up.
The College told me to evaluate the existing clinic. What does that mean in practice?
The checklist’s words are that if you are purchasing an existing business, you should evaluate the existing setup of the clinic and make any improvements necessary to ensure patient safety. In practice: walk the space with someone who knows the Infection Control Standard, list what is missing or non-compliant, cost it, and decide whether the cost belongs in your offer. Do it during the conditional period, because afterwards the price is fixed and the work is not.
The unit was retail. Can I just move a clinic in?
Not without checking two things. Under the Building Code Act a permit is required for a change of use, even with no construction, where the change would increase hazard as determined under the Code — and the City of Toronto states the permit requirement for a change of use without that qualification. Separately, compliance with the zoning by-law is required whether or not a permit is. Confirm both with the City rather than assuming, because some properties sit under former municipal by-laws.
Does AODA apply to a small clinic with two employees?
Yes. The accessibility rules apply to every business with at least one employee. At one to nineteen employees you need accessibility policies, training on the Human Rights Code and accessible customer service, accessible employment and information practices, and accessible public spaces for new construction and renovations, with no compliance report required. The College’s own checklist also directs you to ensure the work space complies with the legislation. At twenty or more employees, a compliance report is due every three years, next by 31 December 2026.
What is the biggest unpriced risk in a clinic lease?
In my experience the restoration obligation at the end of term, because a clinic fit-out is extensive and a lease may require you to return the premises to base building condition. Close behind it: a narrow permitted use clause that does not cover a service you intend to add, an assignment clause giving the landlord absolute discretion despite the Commercial Tenancies Act reasonableness proviso, and a remaining term too short to recover the fit-out. Have all of them read before the offer is firm.
Sources
- College of Physiotherapists of Ontario — Opening a Practice Checklist
- College of Physiotherapists of Ontario — Infection Control Standard
- Government of Ontario — Accessibility rules for businesses and non-profits
- Ontario e-Laws — Integrated Accessibility Standards Regulation, O. Reg. 191/11
- Ontario e-Laws — Building Code Act, 1992, S.O. 1992, c. 23
- City of Toronto — When Do I Need a Building Permit?
- City of Toronto — Zoning By-law 569-2013
- Ontario e-Laws — Commercial Tenancies Act, R.S.O. 1990, c. L.7
ABOUT TO SIGN FOR A PHYSIOTHERAPY CLINIC SPACE?
Because no regulator inspects these premises, the lease and the zoning confirmation are doing all the work. I read both before your offer goes firm, and I build the conditions that let you act on what they say. Toronto, Etobicoke, Mississauga and the west GTA.
Book a 15-minute call or call or text 833-330-1925.
I cannot tell you how many sinks the standard requires, because it does not say. I can tell you to count the ones that are there and ask the right person whether they are enough.
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Jatin Dua is Broker of Record and co-founder of RE/MAX Quantum Realty, Brokerage, Unit 101, 799 The Queensway, Etobicoke. Four-plus years in the GTA and more than $100M in sales volume. He works on commercial and business purchases across Toronto and the west GTA.
This is general professional commentary from a Broker of Record on commercial and business acquisitions in Ontario. It is not legal, tax or accounting advice, and it does not create any professional relationship. Whether a licence transfers, how a purchase should be structured, what tax applies and what a regulator will require on your particular file are questions for your lawyer, your accountant and the regulator itself. Rules, fees and published requirements change — verify anything you intend to rely on against the primary source on the day you rely on it.