LIC 812 - Detail Supportive Information

Form LIC 812 is used to provide additional detailed information related to specific incidents, complaints, or investigations in licensed facilities in California. The form is completed by facility staff or authorized personnel and includes supplemental documentation, reports, witness statements, photographs, or any other relevant information that supports the understanding and resolution of the matter at hand. By utilizing this form, facilities contribute to the comprehensive documentation of incidents, facilitate accurate assessment, and assist in the determination of appropriate actions or resolutions.