LIC 9158 - Telecommunications Device Notification
Form LIC 9158 is used by care facilities in California to notify the Department of Social Services about the presence of a telecommunications device within the facility.
LIC 9163 - Request Live Scan Service - Community Care Licensing
Form LIC 9163 is used to request Live Scan services for individuals seeking employment or volunteer positions in community care licensing programs in California.
LIC 9163B - Request Live Scan Service - Long Term Care OMBUDSMAN
Form LIC 9163B is used to request Live Scan services for individuals involved in Long Term Care Ombudsman programs in California. This form is completed by the applicant and submitted to authorized Live Scan service providers, who capture the applicant's fingerprints electronically.
LIC 9165 - Board Of Director Statement
Form LIC 9165 is used by care facilities in California to provide a statement detailing the members of their board of directors. This form includes information such as the names, addresses, and contact details of each board member.
LIC 9182 - Criminal Background Clearance Transfer Request
Form LIC 9182 is used to request the transfer of a criminal background clearance for individuals who have previously been cleared for employment or volunteer positions in care facilities in California.
LIC 9188 - Criminal Record Exemption Transfer Request
Form LIC 9188 is used to request the transfer of a criminal record exemption for individuals who have previously been granted an exemption to work or volunteer in care facilities in California.
LIC 9200 - Pre-Licensing Facility Evaluation Checklist
Form LIC 9200 is used as a checklist during the pre-licensing evaluation of child care facilities in California. It provides a comprehensive list of items that need to be assessed and evaluated before granting a child care license.
LIC 9211 - Request For Inactive Child Care License Status
Form LIC 9211 is used by child care providers in California to request an inactive status for their child care license. This form is typically utilized when a provider temporarily suspends their child care services and wants to maintain their license without actively operating.
LIC 9214 - Application for Administration Certification - Administrator Certification Program
Form LIC 9214 is used by individuals seeking administrator certification in the care facility setting in California.
LIC 9216 - Complaint And Type A Violation Log
Form LIC 9216 is used by care facilities in California to document complaints received and Type A violations identified within their operations.