The LIC 624 LE, also known as the Law Enforcement Contact Report, is a form used to document any interactions or contact between law enforcement agencies and child care centers or family child care homes. This form helps in reporting incidents, such as arrests, investigations, or any relevant information that may impact the safety and well-being of children in these settings.
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. This roster helps track attendance, monitor completion of educational requirements, and maintain accurate records of individuals who have participated in approved courses.
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. Vendors may include textbook publishers, online learning platforms, training material suppliers, and other entities that support the educational needs of administrators in care facilities.
Form LIC 9140A is used to request the addition or replacement of an instructor within the Administrator Certification Program in California. This form allows course providers to submit relevant details about the instructor, such as qualifications, experience, and expertise in the subject matter. By completing this form, providers ensure that the instructors delivering the approved courses meet the necessary criteria set forth by the Administrator Certification Program.
Form LIC 9140 is utilized by individuals or organizations seeking approval for new courses within the Administrator Certification Program in California. The form allows course providers to submit detailed information about the proposed course, including its objectives, curriculum outline, instructor qualifications, instructional methods, and assessment strategies. By completing this form and obtaining course approval, providers can offer educational opportunities that meet the standards and requirements established by the Administrator Certification Program.
Form LIC 9139 is used for the renewal of continuing education course approval within the Administrator Certification Program in California. This form is utilized by individuals or organizations offering courses intended for administrators in various care facilities, such as assisted living facilities or residential care homes. It allows providers to request the ongoing approval and renewal of their courses, ensuring that they meet the required educational standards and guidelines set forth by the Administrator Certification Program.
Form LIC 9128 is used by foster family agencies in California to provide a program statement that outlines their approach, goals, and services related to fostering children. The program statement includes information on recruitment and training of foster families, support services provided, case management practices, collaboration with other agencies, and adherence to licensing regulations.
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. It includes detailed information such as the resident's name, medication details (name, dosage, frequency), administration dates, staff signatures, and any associated side effects or observations.
Form LIC 9123 is an inspection checklist specifically designed for residential care facilities for the elderly (RCFEs) in California. The form provides a comprehensive list of items to be evaluated during facility inspections, including areas such as resident care, staff qualifications, safety measures, health services, medication management, record-keeping, and compliance with licensing regulations specific to RCFEs.
Form LIC 9058 is designed to inform applicants and licensees of their rights during the licensing process in California. The form outlines the rights and protections afforded to individuals seeking licensure or holding a license, including the right to nondiscrimination, privacy, due process, and fair treatment. It may also provide information on the appeals process and the procedures for filing complaints or grievances.