Forms and documents
LIC 809 - Facility Evaluation Report
Form LIC 809 is used for conducting facility evaluations in licensed facilities in California.
LIC 808 Plan For Epidemic Outbreak Specific to COVID 19 Mitigation Plan Report
Form LIC 808 is a comprehensive plan that outlines specific mitigation strategies for epidemic outbreaks, with a focus on addressing the COVID-19 pandemic.
LIC 701B - Gastrostomy - Tube Care Consent/Verification
The LIC 701B form, Gastrostomy - Tube Care Consent/Verification, is used to obtain consent from parents or authorized representatives regarding the care and maintenance of a child's gastrostomy tube.
LIC 702 - Child's Preadmission Health History - Parent/Authorized Representative Report
The LIC 702 form, Child's Preadmission Health History - Parent/Authorized Representative Report, serves as a comprehensive health history questionnaire filled out by parents or authorized representatives during the enrollment process of a child in a child care center or family child care home.
LIC 701A - Gastrostomy - Tube Care: Physician's Checklist
The LIC 701A form, Gastrostomy - Tube Care: Physician's Checklist, is used by physicians to provide guidance and instructions for the care and management of children with gastrostomy tubes.
LIC 701 - Physician's Report - Child Care Centers
The LIC 701 form, Physician's Report - Child Care Centers, is a document completed by a licensed physician or authorized health care professional.
LIC 700 - Identification And Emergency Information Child Care Centers/Family Child Care Homes
The LIC 700 form, Identification And Emergency Information Child Care Centers/Family Child Care Homes, serves as a comprehensive record that collects vital identification and emergency contact details of children enrolled in child care centers or family child care homes.
LIC 627B - Consent For Emergency Medical Treatment - Children's Residential Facilities
The LIC 627B form, Consent For Emergency Medical Treatment - Children's Residential Facilities, is designed to secure permission from parents or authorized representatives for emergency medical treatment for children residing in residential facilities.
LIC 627A - Consent To A Medical Examination
The LIC 627A form, Consent To A Medical Examination, is utilized to obtain parental or authorized representative consent for a child to undergo a medical examination.
LIC 622B - Psychotropic Medication Administration Record
Form LIC 622B is a specialized medication administration record used for psychotropic medications in licensed facilities in California. The form is completed by authorized staff members who administer psychotropic medications to residents or participants.