LIC 500 - Personnel Report

Form LIC 500 is a personnel report used by licensed facilities in California to provide information about their employees or staff members. The form is completed by the facility operator or licensee and includes details such as the employee's name, position, date of hire, qualifications, work history, and any relevant certifications or training. By utilizing this form, facility operators maintain accurate records of personnel employed in their facilities, ensuring compliance with licensing requirements, and promoting the selection of qualified individuals to provide care and support services.