Forms and documents
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 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 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 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 9098 - Proof Of Correction
Form LIC 9098 is utilized to provide proof of correction for deficiencies identified during inspections or investigations in licensed facilities in California.
LIC 9058 - Applicant/Licensee Rights
Form LIC 9058 is designed to inform applicants and licensees of their rights during the licensing process in California.
LIC 9054 - Local Fire Inspection Authority Information
Form LIC 9054 provides information about the local fire inspection authority to licensed facilities in California.
LIC 9031 - Notice Of Temporary Suspension Order Of License
Form LIC 9031 is used to notify licensed facilities in California of a temporary suspension order affecting their license.
LIC 9029B - Statement Of Facts Preparation Checklist
Form LIC 9029B is a preparation checklist used in the creation of a statement of facts regarding incidents, complaints, or investigations in licensed facilities in California.
LIC 989A - Non-Confidential Records Request Form
Form LIC 989A is used to request non-confidential records from licensed facilities in California. The form is completed by individuals or organizations seeking access to specific records that are not confidential or protected by privacy laws.