Forms and documents
LIC 9123 - FacilityВ Inspection Checklist - Residential Care Facility For The Elderly
Form LIC 9123 is an inspection checklist specifically designed for residential care facilities for the elderly (RCFEs) in California.
LIC 9122A Facility Inspection Checklist Small Family Home
Form LIC 9122A is an inspection checklist specifically designed for small family homes in California.
LIC 9121 - Facility Visit Checklist Family Child Care
Form LIC 9121 is a facility visit checklist specifically designed for family child care providers in California.
LIC 9120A - Licensed Facility Inspection Checklist Adult Care Facilities
Form LIC 9120A is a licensed facility inspection checklist specifically designed for adult care facilities in California.
LIC 9119 YHPC - Facility Inspection Checklist Youth Homelessness Prevention Center
Form LIC 9119 YHPC is an inspection checklist specifically designed for youth homelessness prevention centers (YHPCs) in California.
LIC 9119 TrSCF - Facility Inspection Checklist Transitional Shelter Care Facility
Form LIC 9119 TrSCF is an inspection checklist specific to transitional shelter care facilities (TrSCFs) in California.
LIC 9141 - Vendor Application/Renewal - Administrator Certification Program
Form LIC 9141 is utilized by vendors who provide goods and services related to the Administrator Certification Program in California. This form allows vendors to apply for initial registration or renew their existing registration.
LIC 9142A - Roster of Participants
Form LIC 9142A is used to maintain a roster of participants in training courses within the Administrator Certification Program in California. Course providers complete this form to document participant information, including names, contact details, course dates, and other relevant data.
LIC 9211 - Request For Inactive Child Care License Status
Form LIC 9211 is used by child care providers in California to request an inactive status for their child care license. This form is typically utilized when a provider temporarily suspends their child care services and wants to maintain their license without actively operating.
LIC 9200 - Pre-Licensing Facility Evaluation Checklist
Form LIC 9200 is used as a checklist during the pre-licensing evaluation of child care facilities in California. It provides a comprehensive list of items that need to be assessed and evaluated before granting a child care license.