Forms and documents
NA 1231 - Cash Assistance Program for Immigrants Notice of Overpayment - Partial Waiver Approval
The NA 1231 form is a Notice of Action provided for the Cash Assistance Program for Immigrants. It specifically addresses cases where an overpayment has occurred, and a partial waiver request has been approved.
NA 1230 - Cash Assistance Program for Immigrants Notice of Overpayment - Waiver Approval
The NA 1230 form is a Notice of Action provided for the Cash Assistance Program for Immigrants. It pertains to cases where an overpayment has occurred, and a waiver request has been approved.
NA 1218 - Notice Of Action - Cash Assistance Program For Immigrants - Notice Of Underpayment
The NA 1218 form is a Notice of Action provided for the Cash Assistance Program for Immigrants. It specifically addresses cases where there has been an underpayment in benefits.
LIC 9268 Form 5-4: Calculation Of Net Operating Expenses
The LIC 9268 Form 5-4 is used to calculate the net operating expenses for facilities regulated by the California Department of Social Services.
LIC 9267 Form 5-3: Calculation Of Long-Term Debt Reserve Amount
The LIC 9267 Form 5-3 is used to calculate the long-term debt reserve amount for facilities regulated by the California Department of Social Services.
LIC 9265 Form 5-1: Long-Term Debt Incurred In A Prior Year
The LIC 9265 Form 5-1 is used to report and document long-term debt that was incurred in a prior year by facilities regulated by the California Department of Social Services.
LIC 9264 Form 1-2: Annual Provider Fee
The LIC 9264 Form 1-2 is used to calculate and collect the annual provider fee from facilities regulated by the California Department of Social Services.
LIC 9263 Form 1-1: Resident Population
The LIC 9263 Form 1-1 is used to document the resident population in various facilities regulated by the California Department of Social Services. This form captures details such as the number of residents, their demographics, special needs or considerations, and any relevant changes over time.
LIC 9242 - В Entrance Checklist Residential Care Facilities For The Elderly
The LIC 9242 form is an entrance checklist specifically tailored for Residential Care Facilities for the Elderly (RCFEs) in California. This checklist is utilized during the admission process for older adults seeking entry into an RCFE.
LIC 9241 - В Entrance Checklist Adult Care Facilities
The LIC 9241 form serves as an entrance checklist used by Adult Care Facilities in California. This checklist is employed during the admission process for adults seeking entry into an Adult Care Facility.