Forms and documents
PUB 387 - California Electronic Benefit Transfer (EBT) Card - The easy, safe, and convenient way to receive your food stamp benefits - Single Column
This single-column form focuses on introducing and promoting the California Electronic Benefit Transfer (EBT) Card as a simple, secure, and convenient method for receiving food stamp benefits.
LIC 401 - Monthly Operating Statement
Form LIC 401 is used by licensed facility operators in California to provide a monthly operating statement detailing the financial aspects of their operations.
LIC 9283 - Infection Control Plan - Adult Day Programs
The LIC 9283 form is an Infection Control Plan specifically developed for Adult Day Programs regulated by the California Department of Social Services. This plan provides guidance and procedures for preventing and managing infections within adult day program settings.
LIC 9020A - Register Of Facility Residents - Residential Care Facilities For The Elderly
Form LIC 9020A is specifically designed for residential care facilities for the elderly (RCFE) in California to maintain a register of facility residents.
LIC 503 - Health Screening Report - Facility Personnel
Form LIC 503 is a health screening report used for facility personnel in licensed facilities in California.
LIC 9217 - Pre-Licensing Readiness Guide - Family Child Care Home
Form LIC 9217 is a readiness guide designed for individuals planning to open a family child care home in California. The form provides detailed information and guidance on the steps involved in establishing a licensed family child care business.
LIC 9227 - Individual Infant Sleeping Plan
Form LIC 9227 is used to develop individualized infant sleeping plans in child care facilities in California. This form addresses safe sleep practices for infants, taking into account factors such as age, developmental stage, and specific needs of each child.
LIC 9052 - Notice Employee Rights
Form LIC 9052 is used to provide notice of employee rights in licensed facilities in California. The form is completed by facility administrators or human resources personnel and outlines various employment rights and protections afforded to employees.
LIC 9040 - Child Care Facility Roster
Form LIC 9040 is used to maintain a roster of children enrolled in child care facilities in California.
LIC 9060 - Resident Theft And Loss Record
Form LIC 9060 is used to document incidents of theft or loss involving residents' personal property in licensed facilities in California.