Forms and documents
LIC 501 - CCL/Personnel Record
Form LIC 501 is a record used to document and maintain personnel information for Community Care Licensing (CCL) purposes in licensed facilities in California.
LIC 421IM - Civil Penalty Assessment Immediate $500 And Repeat Violations
Form LIC 421IM is a civil penalty assessment form used by the California Department of Social Services (CDSS) to address immediate and repeat violations in licensed facilities.
LIC 500 - Personnel Report
Form LIC 500 is a personnel report used by licensed facilities in California to provide information about their employees or staff members.
LIC 421FC - Civil Penalty Assessment Failure To Correct And Repeat Violations
Form LIC 421FC is a civil penalty assessment form used by the California Department of Social Services (CDSS) to address repeated violations and failure to correct deficiencies in licensed facilities.
LIC 421D - Civil Penalty Assessment Death/Serious Bodily Injury/Physical Abuse
The LIC 421D form is specifically designed by the California Department of Social Services for assessing civil penalties in cases involving death, serious bodily injury, or physical abuse.
LIC 421D - Civil Penalty Assessment Death/Serious Injury/Physical Abuse
The LIC 421D form is used by the California Department of Social Services to assess civil penalties in cases involving death, serious injury, or physical abuse.
LIC 421D - Civil Penalty Assessment Death/Serious Bodily Injury/Physical Abuse
Form LIC 421D is a civil penalty assessment form used by the California Department of Social Services (CDSS) in cases involving death, serious bodily injury, or physical abuse in licensed facilities.
LIC 421CC - Civil Penalty Assessment Child Care
Form LIC 421CC is a civil penalty assessment form specific to child care facilities in California.
LIC 421A - Civil Penalty Assessment
Form LIC 421A is used for the assessment of civil penalties against licensed facilities in California.
LIC 421BG - Civil Penalty Assessment Caregiver Background Check
Form LIC 421BG is a specific civil penalty assessment form related to caregiver background checks in licensed facilities in California.