The application for renewal of authorisation is sent by the head of the managing body to the Director General of the Regional Health Agency no later than six months before the current authorisation expires. Renewal is granted, for a period of five years, by the Director General of the Regional Health Agency within six months of receipt of the application, in accordance with the conditions defined in Article D. 3121-23 and after evaluation of the centre’s activity and, where appropriate, after an on-site visit by an agent mentioned in Article L. 1421-1.