LIC 421D - Civil Penalty Assessment Death/Serious Bodily Injury/Physical Abuse
Form LIC 421D is a civil penalty assessment form used by the California Department of Social Services (CDSS) in cases involving death, serious bodily injury, or physical abuse in licensed facilities.
LIC 421CC - Civil Penalty Assessment Child Care
Form LIC 421CC is a civil penalty assessment form specific to child care facilities in California.
LIC 421A - Civil Penalty Assessment
Form LIC 421A is used for the assessment of civil penalties against licensed facilities in California.
LIC 421BG - Civil Penalty Assessment Caregiver Background Check
Form LIC 421BG is a specific civil penalty assessment form related to caregiver background checks in licensed facilities in California.
LIC 420 - Budget Information
Form LIC 420 is used to provide budget information for licensed facilities in California. The form is completed by the facility operator or licensee and includes details of projected income and expenses, anticipated cash flow, and other financial aspects related to the facility's operation.
LIC 406 - Client/Resident Cash Sheet
Form LIC 406 is used to document and track cash transactions related to clients or residents in licensed facilities in California. The form is completed by facility staff and captures details of cash received, disbursed, or held on behalf of clients or residents.
LIC 404 - Financial Information Release And Verification
Form LIC 404 is used to obtain the release and verification of financial information from individuals or entities associated with licensed facilities in California.
LIC 405 - Record Of Client's/Resident's Safeguarded Cash Resources
Form LIC 405 is used to maintain a record of safeguarded cash resources belonging to clients or residents in licensed facilities in California.
LIC 403 - Balance Sheet
Form LIC 403 is used by licensed facility operators in California to provide a balance sheet, which presents the financial condition of the facility at a specific point in time.
LIC 403A - Balance Sheet Supplemental Schedule
Form LIC 403A is a supplemental schedule used in conjunction with the Balance Sheet (LIC 403) for licensed facilities in California. The form provides additional details, explanations, or breakdowns of specific balance sheet components, such as assets, liabilities, and equity.