Form LIC 9119 CTF is an inspection checklist specific to community treatment facilities (CTFs) in California. The form provides a detailed checklist of items to be evaluated during facility inspections, including areas such as treatment programs, staff qualifications, clinical services, medication management, rehabilitation practices, safety protocols, and overall compliance with licensing regulations.
Form LIC 613B is used to outline the personal rights of children residing in residential care facilities in California. The form is provided to children, their parents, or legal guardians upon admission to the facility, and it clearly states their rights regarding privacy, communication, visitation, religious practices, education, access to medical care, and grievance procedures.
Form LIC 9119 CN is an inspection checklist specifically designed for crisis nurseries in California. The form provides a comprehensive list of items to be evaluated during facility inspections, including areas such as child care practices, staff qualifications, safety measures, health and nutrition, supervision protocols, record-keeping, and compliance with licensing regulations specific to crisis nurseries. Inspectors utilize this form to assess the operations of crisis nurseries, ensure the well-being and safety of children in their care, and promote adherence to licensing standards.
Form LIC 610E is an emergency disaster plan specifically tailored for Residential Care Facilities for the Elderly (RCFE) in California. The form is completed by the RCFE operator or administrator and provides detailed guidelines and procedures to address various emergency situations or disasters. It covers areas such as evacuation procedures, communication plans, emergency contacts, sheltering arrangements, and the provision of necessary resources during emergencies.
Form LIC 856D is used to notify licensed facilities in California when a complaint has been determined to be unfounded. The form is completed by the licensing agency or authorized personnel and outlines the findings of the investigation, stating that there is no factual basis for the allegations made in the complaint. By utilizing this form, facilities receive official notification of the unfounded complaint, ensuring transparency, protecting their reputation, and complying with licensing regulations regarding complaint resolution and reporting.
Form LIC 610D is an emergency disaster plan specifically designed for Adult Day Programs, Adult Residential Facilities, Residential Care Facilities for the Chronically Ill, and Social Rehabilitation Facilities in California. The form is completed by the facility operator or administrator and outlines comprehensive procedures and protocols to address potential emergencies or disasters. It includes information about evacuation plans, emergency contacts, communication strategies, transportation arrangements for residents or participants, and necessary supplies.
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. It verifies that parents or guardians understand and authorize the administration of feedings, medication, and necessary medical interventions related to the gastrostomy tube, as well as the responsibility of the child care provider in providing such care.
Form LIC 856C is used to notify licensed facilities in California when a complaint has been determined to be unsubstantiated. The form is completed by the licensing agency or authorized personnel and provides information about the complaint, the investigation process, and the conclusion that no evidence supports the allegations made in the complaint. By utilizing this form, facilities receive formal notification of the unsubstantiated complaint, ensuring transparency, protecting their reputation, and complying with licensing regulations related to complaint resolution.
Form LIC 856B is used to notify licensed facilities in California when a complaint has been substantiated. The form is completed by the licensing agency or authorized personnel and includes details about the complaint, findings of the investigation, any violations identified, and the recommended corrective actions. By utilizing this form, facilities receive official notification of substantiated complaints, enabling them to address deficiencies, implement corrective measures, and comply with licensing regulations relating to complaint resolution and quality improvement.
Form LIC 856A is used to notify licensed facilities in California of the intake of a complaint. The form is completed by the licensing agency or authorized personnel and includes essential information such as the complainant's name, nature of the complaint, date received, and any initial actions taken. By utilizing this form, facilities are informed about complaints filed against them, allowing them to initiate appropriate response protocols, conduct internal investigations if necessary, and ensure compliance with regulatory requirements related to complaint management.