How to Become an Occupational Therapist in California

Imagine a career where your daily work helps someone regain the ability to walk, hold a spoon, or return to school after an injury. This is the essence of occupational therapy—a profession rooted in empathy, purpose, and the power of human potential.

To practice in California, aspiring occupational therapists must follow a specific sequence of educational, certification, and licensing steps. Each phase builds upon the last, developing the technical and interpersonal skills needed to support patients from all backgrounds.

Whether you are exploring a new career or ready to take your next academic leap, this guide outlines how to become an occupational therapist in California and how Alliant International University can help you succeed.

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What Does an Occupational Therapist Do?

So, what does an occupational therapist do? OTs are trained professionals who help individuals gain, recover, or maintain the ability to perform essential daily tasks. These tasks (referred to as "occupations") can include everything from brushing teeth and preparing meals to returning to work, attending school, or managing transportation.

Why is occupational therapy important? OTs empower clients to navigate their world with greater independence, dignity, and confidence.

Core Responsibilities of an Occupational Therapist

OTs take on a wide range of responsibilities that require both clinical precision and human-centered care. They blend science and creativity to design interventions that are as unique as the people they serve.

Day-to-day work can include:¹

• Assessing patient needs through interviews, observation, and standardized tools
• Creating customized treatment plans tailored to individual goals and abilities
• Implementing therapeutic interventions
• Educating caregivers and families to support progress outside of therapy
• Collaborating with other healthcare professionals for holistic care

Every treatment plan is deeply personalized, ensuring that progress is meaningful and sustainable for each patient.

Who Occupational Therapists Work With

Occupational therapists serve patients of all ages, offering tailored support for every stage of life. From helping a child develop fine motor skills to assisting an older adult in adapting to mobility challenges, OTs play a critical role in promoting independence and improving overall quality of life.

OTs commonly work with:²

• Children with developmental delays or sensory integration challenges
• Adults recovering from injuries, surgeries, or strokes
• Older adults managing chronic conditions or age-related limitations

This versatility makes occupational therapy a deeply rewarding profession, one that meets people wherever they are in their journey.

Occupational Therapist Work Environments

A wide variety of professional environments need OTs, each offering unique opportunities to make a difference. Depending on the setting, OTs may focus on rehabilitation, prevention, education, or long-term care. Settings can include:³

• Hospitals and outpatient clinics
• Schools and early intervention programs
• Rehabilitation centers and skilled nursing facilities
• Home healthcare and community organizations

Becoming an occupational therapist requires more than compassion and curiosity—it takes structured training, clinical experience, and a deep commitment to improving lives. If you are ready to turn that calling into a career, the journey begins with five essential steps.

5 Steps to Become an Occupational Therapist in California

Choosing a career in occupational therapy means committing to a path that blends purpose with professional growth. In California, that path is defined by a series of essential steps—each one designed to build your knowledge, sharpen your skills, and prepare you to make a lasting impact:

#1 Earn a Bachelor’s Degree

The first step to becoming an occupational therapist is obtaining a bachelor’s degree. While no specific undergraduate major is universally required, students should focus on programs in:⁴

• Psychology
• Biology
• Health sciences
• Kinesiology
• Sociology

Choosing one of these majors provides a strong foundation for understanding human behavior, anatomy, and wellness—all essential subjects for future OT coursework and clinical practice. What matters most is that your coursework includes prerequisite subjects commonly required by OT graduate programs, such as:⁵

• Anatomy and physiology
• Statistics
• Developmental psychology
• Medical terminology
• Sociology or anthropology

Many programs also expect candidates to complete volunteer hours or clinical observation under a licensed OT. These experiences not only strengthen applications but also offer valuable insight into the profession.

#2 Enroll in an Accredited Occupational Therapy Program

After completing a bachelor’s degree, the next step is to pursue a graduate degree in occupational therapy from an accredited institution. In California and across the U.S., aspiring OTs can choose between:⁶

• A Master of Occupational Therapy (MOT): This master degree focuses on the essential clinical skills and knowledge required for entry-level occupational therapy practice. Students receive in-depth training in assessment techniques, intervention planning, and therapeutic approaches while also learning how to collaborate with interdisciplinary teams and support diverse populations across various settings.
• A Doctorate in Occupational Therapy (OTD): In addition to providing a strong foundation in clinical care, this degree includes advanced courses in research, policy, leadership, and systems-level thinking. The OTD is designed for students interested in expanding their impact beyond direct patient care—whether through innovation, advocacy, academic roles, or program development.

Regardless of the degree path, the program must meet the requirements of the Accreditation Council for Occupational Therapy Education (ACOTE).

Alliant International University offers an accredited OT program designed to prepare students for clinical success and leadership in the field. Through rigorous coursework, supportive faculty, and a hands-on learning environment, the program equips graduates with both the technical knowledge and the compassionate approach needed to serve diverse communities.

#3 Complete Clinical Fieldwork

Fieldwork is a cornerstone of occupational therapy education. Graduate students must complete two distinct levels of field experience:⁷

• Level I fieldwork: This introductory field experience is designed to expose students to a variety of occupational therapy settings and patient populations. Through observation, case-based discussions, and limited patient engagement, students begin to understand the roles, responsibilities, and daily workflows of practicing occupational therapists. Level I placements emphasize critical thinking, reflection, and professional behavior, laying the groundwork for more advanced clinical involvement.
• Level II fieldwork: This is an intensive, hands-on training experience that places students directly into clinical environments under the supervision of licensed occupational therapists. Students are expected to progressively take on greater responsibility in evaluating patients, planning interventions, and implementing treatment strategies.

Level II fieldwork typically includes at least 24 weeks of full-time placement, split across different practice areas such as:⁸

• Pediatrics
• Mental health
• Physical rehabilitation
• Geriatrics

These immersive experiences are not only critical for developing clinical expertise, but they also serve as a transformative bridge between student and professional. This helps shape the confidence, adaptability, and real-world insight needed to thrive in a career that changes lives.

#4 Pass the NBCOT Exam

After graduating from an accredited OT program and completing all required fieldwork, candidates must pass the National Board for Certification in Occupational Therapy (NBCOT) examination to become registered occupational therapists.⁹

The NBCOT exam evaluates core competencies across multiple domains that are essential for safe, ethical, and effective patient care, including:¹⁰

• Evaluation and assessment techniques
• Intervention planning and implementation
• Ethics and professional conduct
• Foundational knowledge in physical and psychosocial conditions

Because of the comprehensive nature of the exam, most students dedicate time and effort to a structured study plan that may include a combination of the following tools:

• NBCOT official practice exams and prep materials
• Review books and flashcards
• Study groups and structured review sessions

Passing the NBCOT exam earns you the title of Occupational Therapist, Registered (OTR)—a key milestone toward licensure.

#5 Obtain Licensure in California

With your NBCOT certification in hand, the final step is to apply for state licensure through the California Board of Occupational Therapy (CBOT).

The CBOT will verify your qualifications and readiness to practice by requiring you to:¹¹

• Submit proof of education and NBCOT certification
• Pass a background check (Live Scan fingerprinting)
• Pay the required application and licensure fees
• Provide documentation of completed fieldwork hours

Once your application is approved, you are officially licensed to practice occupational therapy in California, allowing you to begin your career and serve your community.

Keep in mind that licensure must be renewed every two years, and OTs are required to complete continuing education to stay current in the field.¹² This ensures that licensed professionals maintain up-to-date knowledge and clinical best practices throughout their careers.

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How Long Does It Take to Become an Occupational Therapist?

The timeline to become a licensed occupational therapist in California typically spans six to eight years, depending on your educational path and clinical experience.¹³ Factors that may impact this timeline include:

• Full-time vs. part-time study
• Gaps between undergraduate and graduate education
• Program availability and clinical placement timing
• Time needed to prepare for and pass the NBCOT exam

While the path may seem long, each stage is vital for building the expertise needed to provide effective, compassionate care.

Start Your Occupational Therapy Journey with Alliant

Is occupational therapy a good career choice? Choosing a career in occupational therapy means committing to a life of service, empowerment, and meaningful human connection. It also means following a clear, structured path that begins with education and ends in licensed, professional practice.

At Alliant International University, students find more than just an education—they discover a community committed to helping them succeed. With expert faculty, immersive clinical opportunities, and a curriculum grounded in real-world application, our occupational therapy program prepares graduates to make an immediate impact.

Ready to take the first step toward a career where your work helps others live more fully? Explore OT program with Alliant International University today and begin building a future defined by purpose.

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Sources: 

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2. “Occupational Therapist.” Cleveland Clinic. February 27, 2024. https://my.clevelandclinic.org/health/articles/24617-occupational-thera…. Accessed April 9, 2025.
3. “Where do occupational therapists work? (8 work environments).” Indeed. March 8, 2025. https://uk.indeed.com/career-advice/finding-a-job/where-do-occupational…. Accessed April 9, 2025.
4. Indeed Editorial Team. “8 Best Majors for Occupational Therapists.” Indeed. March 26, 2025. https://www.indeed.com/career-advice/career-development/major-occupatio…. Accessed April 9, 2025.
5. Catherine Hoyt. “Which OT Degree? (OT, OTD, PPOTD & More!).” OT Potential. May 1, 2024. https://otpotential.com/blog/occupational-therapy-degree. Accessed April 9, 2025.
6. Catherine Hoyt. “Which OT Degree? (OT, OTD, PPOTD & More!).” OT Potential. May 1, 2024. https://otpotential.com/blog/occupational-therapy-degree. Accessed April 9, 2025.
7. “Commission on Education (COE) Guidelines for Occupational Therapy Fieldwork Education.” American Occupational Therapy Association. May 2024. https://www.aota.org/education/fieldwork/. Accessed April 9, 2025.
8. “Fieldwork: ACOTE Section C Standards.” Accreditation Council for Occupational Therapy Education. 2025. https://acoteonline.org/frequently-asked-questions/. Accessed April 9, 2025.
9. Sarah Lyon. “How to Become an Occupational Therapist (2025).” OT Potential. March 11, 2025. https://otpotential.com/blog/become-an-occupational-therapist. Accessed April 9, 2025.
10. “Foundations of the Certification Examinations.” National Board for Certification in Occupational Therapy. 2025. https://www.nbcot.org/exam-info/foundations. Accessed April 9, 2025.
11. “How to Become an Occupational Therapist in California.” OccupationalTherapyLicense.org. 2025. https://www.occupationaltherapylicense.org/california-occupational-ther…. Accessed April 9, 2025.
12. “Find your state licensure answers.”  American Occupational Therapy Association. 2025. https://www.aota.org/career/state-licensure/frequently-asked-questions. Accessed April 9, 2025.
13. “Occupational Therapist.” Cleveland Clinic. February 27, 2024. https://my.clevelandclinic.org/health/articles/24617-occupational-thera…. Accessed April 9, 2025.