Forms and documents
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 9269 Form 5-5: Annual Reserve Certification
The LIC 9269 Form 5-5 is used by facilities regulated by the California Department of Social Services to certify their annual reserves. This form verifies that the facility has met the required reserve amounts based on applicable regulations and guidelines.
LIC 9270 Form 7-1: Report On CCRC Monthly Care Fees
The LIC 9270 Form 7-1 is used to report monthly care fees for Continuing Care Retirement Communities (CCRCs) regulated by the California Department of Social Services. This form captures information regarding the fees charged to residents for various levels of care provided within the CCRC.
LIC 9271 Form 9-1: Calculation Of Refund Reserve Amount
The LIC 9271 Form 9-1 is used to calculate the refund reserve amount for facilities regulated by the California Department of Social Services.
LIC 9272 Annual Report Checklist
The LIC 9272 form is an Annual Report Checklist used by entities regulated by the California Department of Social Services. This checklist ensures that all necessary information and documentation are included in the annual report submitted to the department.
LIC 9273 Continuing Care Retirement Community Disclosure Statement
The LIC 9273 form is a Continuing Care Retirement Community (CCRC) Disclosure Statement required by the California Department of Social Services. This statement aims to provide prospective residents with essential information about CCRCs before making decisions regarding residency.
LIC 9274 Key Indicators Report
The LIC 9274 form is a Key Indicators Report used by facilities regulated by the California Department of Social Services. This report provides key performance indicators related to the facility's operations, service delivery, and compliance with regulations.
LIC 9275 - External Water Sampler Self-Certification Form
The LIC 9275 form is an External Water Sampler Self-Certification Form used by water sampling professionals or entities responsible for collecting water samples for facilities regulated by the California Department of Social Services.
LIC 9276 Child Care Center Sampling Checklist Form
The LIC 9276 form is a Child Care Center Sampling Checklist Form used by the California Department of Social Services for monitoring and assessing child care centers within its jurisdiction.
IC 9277LUA - Guardian Licensee User Access Form
The IC 9277LUA form, also known as the Guardian Licensee User Access Form, is used by the California Department of Social Services to authorize access to specific systems or information for individuals acting as guardians for licensees.