Occupational therapy can be a rewarding career for professionals who are interested in helping people improve their independence and ability to participate more fully in everyday life. However, becoming qualified to provide this type of care requires going through several years of education, clinical training, and professional preparation.
For aspiring occupational therapists in California, the process also involves meeting the state-specific licensing requirements and securing authorization for practice from the state board.
In the article below, we will explain how to become an occupational therapist in California, walk you through each stage of the qualification process, and take a closer look at the opportunities available for advancing into specialized areas of occupational therapy practice.
Understanding the Occupational Therapy Profession in California
Occupational therapists are licensed healthcare professionals whose job it is to help people whose injuries, illnesses, disabilities, developmental conditions, or other health challenges affect their ability to perform everyday activities and function more independently.
They work with patients whose physical, cognitive, developmental, sensory, or other challenges affect their ability to take care of themselves, participate in school or work, manage household responsibilities, and carry out other parts of their daily routines.
Rather than focusing only on the condition affecting the patient, occupational therapists consider how that condition influences the person’s ability to function in everyday situations. Based on this understanding, they develop individualized treatment approaches that help patients build new skills, recover abilities they have lost, or learn alternative ways to perform activities that have become difficult.
The type of support OTs can provide can vary considerably depending on the patient, the challenges affecting their daily life, and the level of assistance they need to function more independently.
For example, an occupational therapist may help a child improve the motor skills needed for school activities, work with an adult recovering from an injury to regain independence in daily tasks, or support an older patient who needs to adapt to changes in their physical or cognitive abilities.
Considering the level of responsibility involved in working with vulnerable populations, occupational therapy is a highly regulated healthcare profession.
This means that individuals who want to practice as OTs in California need to complete a formal education and clinical training process, demonstrate their professional competency, and obtain the appropriate state license before they’re allowed to work independently.
Common Work Settings for Occupational Therapists in California
Occupational therapists in California can work in a wide range of healthcare, educational, and community-based settings, with the exact nature of their work often depending on the types of patients they serve and the functional challenges those patients are experiencing.
Some of the most common work environments for professional OTs include:
- Hospitals, where OTs may work with patients recovering from surgery, serious injuries, neurological conditions, or other medical problems that affect their ability to function independently
- Outpatient rehabilitation centers, where therapists typically work with patients who do not require hospitalization but still need ongoing support to improve their ability to perform everyday activities
- Skilled nursing and residential care facilities, where occupational therapists often work with older adults or patients recovering from illnesses and injuries that have reduced their independence
- Schools, where OTs can support children whose physical, sensory, developmental, or other challenges affect their ability to participate in classroom activities and complete school-related tasks
- Home health settings, where therapists provide services in the patient’s own living environment and can address functional difficulties directly within the surroundings in which everyday activities take place
- Mental health and community-based facilities, where occupational therapy may focus on helping patients develop routines, coping strategies, social skills, and other abilities that support more independent participation in daily life
While the specific responsibilities of occupational therapists can differ considerably between these settings, they all work toward helping patients overcome functional limitations and become more independent in their everyday lives.
Becoming an OT in CA: Qualifications Breakdown
Now that we have a better understanding of the occupational therapy profession, we can take a quick look at the key qualifications aspiring OTs need to achieve in order to qualify for professional therapy practice in the state of California. These include:
- Complete a bachelor’s degree and the prerequisite coursework required for admission to an occupational therapy graduate program
- Earn an entry-level master’s or doctoral degree in occupational therapy from an ACOTE-accredited program
- Accumulate the required Level I and Level II fieldwork experience as part of their professional education
- Pass the Occupational Therapist Registered examination administered by the National Board for Certification in Occupational Therapy
- Obtain an occupational therapy license from the California Board of Occupational Therapy
These requirements are set in place to make sure that prospective OTs have the academic knowledge and practical skills to properly assess patients’ needs and treat them safely and reliably.
How to Become an Occupational Therapist in California: Step by Step
Having outlined the key qualifications required for professional occupational therapy practice in California, we can now move on to the practical part of our guide and break down the process of becoming an OT in the state step by step.
Complete the Undergraduate Education Required for OT Admission
The first step toward becoming an occupational therapist in California is to enroll in a bachelor’s degree program at an accredited college or university. This is the earliest stage of occupational therapy education and typically takes around four years of full-time study to complete.
Given that becoming an occupational therapist does not require a bachelor’s degree in one specific field, aspiring OTs have considerable flexibility when choosing their undergraduate major. However, the main thing they do need to think about at this stage is meeting the admission requirements for the occupational therapy program they will enroll in the future.
While individual occupational therapy programs establish their own admission criteria, most require applicants to complete prerequisite coursework in subjects such as anatomy, physiology, and psychology. Depending on the program, students may also need additional coursework in areas such as statistics, human development, or other related subjects.
For this reason, it is a good idea for undergrad students to choose the OT programs they may eventually want to apply to early in the process and try to incorporate their prerequisite requirements into their undergraduate studies.
Earn an Accredited Occupational Therapy Graduate Degree
After completing their undergraduate education and meeting the necessary admission requirements, aspiring OTs can move on to the graduate-level stage of their training. At this point in their academic journey, they can choose between two entry-level degree options:
- Master’s Degree in Occupational Therapy – This is the shorter of the two pathways and provides students with the academic and clinical preparation required for entry-level occupational therapy practice. These programs typically take two years to complete.
- Doctor of Occupational Therapy (OTD) – This degree covers the same core areas of professional OT education but includes additional preparation in areas such as leadership, research, advocacy, and program development. OTD students also need to complete a doctoral capstone and culminating project.
Throughout their graduate education, OT students study areas such as patient assessment, treatment planning, clinical reasoning, evidence-based practice, and therapeutic approaches for working with different patient populations.
Their professional education also includes a supervised practical component called fieldwork, where they can apply what they learn in the classroom while gaining experience working with patients in real clinical settings.
One key point we must make here is that regardless of whether they enroll in a master’s degree or an OTD program, students need to make sure they choose a program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE), as only these programs can qualify them for OT licensure.
Accumulate the Required Occupational Therapy Fieldwork Experience
As we just mentioned, in addition to completing their academic coursework, every occupational therapy student also needs to accumulate supervised fieldwork experience as part of their graduate education. This practical component is divided into two levels, each of which serves a different purpose in the student’s clinical development:
- Level I Fieldwork is the introductory experience that is designed to expose students to occupational therapy practice and help them develop a better understanding of the needs of different patient populations
- Level II Fieldwork is the more intensive stage of practical training, during which students take on greater responsibility for providing occupational therapy services under supervision. OT students need to complete a minimum of 24 weeks of full-time Level II fieldwork, although programs may allow them to satisfy the requirement on a part-time basis over a longer period
Once students complete the required academic coursework and fieldwork experience, they will have satisfied the education and practical training requirements of their occupational therapy program and can move on to the examination stage of the qualification process.
Pass the National NBCOT Occupational Therapist Examination
With their graduate education and fieldwork experience complete, aspiring OTs can move on to the examination stage of the qualification process and take the Occupational Therapist Registered (OTR) certification exam administered by the National Board for Certification in Occupational Therapy (NBCOT).
The NBCOT exam is designed to assess whether candidates have the knowledge and professional competency needed to enter occupational therapy practice. Candidates who successfully pass the examination earn the OTR credential and become eligible for OT licensure in California.
We should also point out that recent graduates who want to begin working before taking the NBCOT exam may be eligible for a limited permit from the California Board of Occupational Therapy. This permit allows qualifying graduates to practice under supervision while waiting to take the national examination, although it is temporary and terminates if the holder receives a failing score.
Obtain Your California Occupational Therapy Professional License
After passing the NBCOT examination, candidates can move on to the final regulatory stage of the qualification process and apply for an occupational therapy license through the California Board.
As part of the application process, candidates need to submit the required application form and fee, provide official transcripts from their qualifying occupational therapy program, and submit their NBCOT examination results.
In addition, they also need to undergo live-scan fingerprinting so that the Board can conduct the required criminal background check as part of its review of their eligibility for licensure.
Once all of the required materials have been submitted, the Board will review the application and verify that the candidate satisfies California’s occupational therapy licensing requirements. If everything checks out, they will be issued a professional OT license and granted authorization to practice occupational therapy in the state.
Begin Working as a Licensed Occupational Therapist in California
The moment a candidate receives their California occupational therapy license, they can officially begin working as a licensed OT in the state. Depending on their professional interests, they may look for employment in hospitals, rehabilitation centers, outpatient clinics, schools, skilled nursing facilities, home health services, and other settings where occupational therapy care is provided.
Professional occupational therapy practitioners have the flexibility to work with different patient populations and develop experience across a variety of areas of practice.
While in the early stages of their careers, they may still be determining which types of patients or clinical settings interest them most, as they become more experienced, they can begin focusing their work on the areas they find particularly rewarding.
For occupational therapists who want to develop deeper expertise in a specific area of practice, there are several postprofessional pathways they can pursue to advance into more specialized roles.
Advancing as an Occupational Therapy Specialist
As occupational therapists continue to gain experience in professional practice, they may begin looking for ways to deepen their knowledge and develop greater expertise in a particular area of OT.
Depending on their career goals, this may involve concentrating their clinical work on a specific patient population, completing structured postprofessional training, or pursuing credentials that formally recognize advanced competency.
The exact pathway an OT chooses will depend on the type of specialist they want to become and the area of practice they intend to pursue. In the sections below, we will take a closer look at the main options available to professionals who want to build on their general occupational therapy experience and advance into more specialized roles.
Complete an AOTA-Approved OT Fellowship Program
Occupational therapists who want to develop more advanced expertise in a particular area of practice can consider completing a fellowship program accredited by the American Occupational Therapy Association.
These are postprofessional training programs designed to help licensed OTs build on the general knowledge and clinical skills they developed during their entry-level education and professional practice.
AOTA-accredited fellowships combine advanced education with intensive mentorship and a clinical caseload focused on a particular area of occupational therapy practice.
Depending on their professional interests, OTs can pursue fellowship training in areas such as pediatrics, gerontology, mental health, neurology, physical rehabilitation, hand therapy and upper extremity, dysphagia, assistive technology, and several other specialties.
To apply, prospective fellows need to have graduated from an ACOTE- or WFOT-accredited occupational therapy program and hold a current OT license or be eligible for licensure in the jurisdiction where the fellowship is offered.
Pursue Formal OT Specialty Credentials
In addition to completing a fellowship, experienced occupational therapists can also pursue advanced certification through the American Occupational Therapy Association to formally demonstrate their expertise in a particular area of practice.
At the moment, AOTA offers three exam-based board certifications for occupational therapists:
- Board Certification in Gerontology (BCG) – For OTs who have developed advanced knowledge and experience working with older adults
- Board Certification in Pediatrics (BCP) – For professionals who specialize in providing occupational therapy services to children, adolescents, and their families
- Board Certification in Physical Rehabilitation (BCPR) – For OTs whose practice focuses on helping patients recover or adapt following injuries, illnesses, disabilities, and other conditions that affect physical function
To qualify for one of these credentials, candidates need to hold a valid license or other recognized professional credential in good standing, have at least three years of experience, and accumulate 3,000 hours of experience in the certification area within the previous five years.
Once they meet these eligibility requirements, they can apply for and pass the certification examination associated with their chosen specialty.
OT Salary and Employment Outlook in California
Having covered the entire qualification process as well as the opportunities available for advancing into more specialized roles, we can now take a look at the earning potential and employment outlook associated with occupational therapy in California.
According to the Bureau of Labor Statistics, there are 12,470 occupational therapists employed in California, and they earn an average annual salary of $113,550, or about $54.59 per hour. In fact, California is the highest-paying state for occupational therapists, according to the BLS.
Naturally, the statewide average provides only a general indication of the earning potential associated with the profession and does not reflect what every occupational therapist in California earns. The actual salary figures can vary depending on factors such as professional experience, employer, work setting, and location within the state.
For example, OTs working in the San Jose metropolitan area earn an average of $134,140 per year, compared with $125,850 for those employed in San Francisco and $112,660 for those working in Los Angeles.
While the BLS does not provide California-specific projections, the broader employment outlook for occupational therapists is also positive. Nationwide, employment in the profession is projected to grow by 14%, which is considerably faster than the 3% average for all occupations.
Closing Thoughts
People whose ability to perform everyday activities has been affected by an injury, illness, disability, developmental condition, or other challenge may need additional support to function more independently. Occupational therapists can provide this support by helping patients develop, recover, or adapt the skills they need to participate more fully in their daily lives.
Becoming an occupational therapist in California is a multi-stage process that requires completing a demanding qualification pathway established for professional practice in the state. For professionals interested in helping people overcome functional challenges and become more independent, occupational therapy can be a very fulfilling career.
Frequently Asked Questions
How long does it take to become an occupational therapist in California?
Becoming an occupational therapist in California can take anywhere between six and seven years from the start of your undergraduate education. This timeframe accounts for around four years of undergraduate study and another two to three years spent completing a graduate occupational therapy program.
Since the required fieldwork is built into the graduate curriculum, students usually complete their supervised clinical training without adding a separate post-graduation stage. After earning their degree, candidates still need to pass the NBCOT examination and secure their California occupational therapy license before they can begin practicing independently.
What is the difference between an OT and an occupational therapy assistant?
The main difference between an occupational therapist and an occupational therapy assistant is the level of responsibility each of these roles takes during patient care. OTs evaluate patients, identify their functional needs, develop treatment plans, and determine the overall direction of therapy.
OTAs, on the other hand, work under the supervision of an OT and help carry out the treatment plan by guiding patients through therapeutic activities, documenting their progress, and reporting changes to the supervising therapist.
To enter the profession, assistants generally need to complete an accredited occupational therapy assistant program, become a certified occupational therapy assistant by passing the NBCOT examination, and obtain an occupational therapy assistant license where required.
How much does an OT get paid in California?
According to the BLS, OTs in California earn an average annual salary of $113,550, however, this statewide average provides only a general indication of earning potential and does not reflect what every OT in California earns.
The actual earnings can vary depending on factors such as experience, employer, and work setting. For example, occupational therapists working in home health care services earn an average of $110,460 per year, compared with $101,740 in skilled nursing facilities, $98,810 in general hospitals, and $85,180 in elementary and secondary schools.