California Department of Social Services

Form LIC 313 is used to provide evidence of a program consultant's qualifications and eligibility to provide consultation services to licensed facilities in California. The form is completed by the program consultant or consulting agency and includes information such as educational background, relevant experience, certifications, and references. By utilizing this form, the California Department of Social Services (CDSS) assesses the program consultant's qualifications and approves them to provide professional guidance and support to licensees in meeting regulatory requirements.

Form LIC 311F outlines the records that must be maintained at a Residential Care Facility for the Elderly (RCFE) in California. The form provides a detailed list of required records, including resident admission records, medication records, incident reports, financial records, service plans, and other pertinent documentation. By utilizing this form, RCFE operators ensure the proper maintenance and organization of records in compliance with licensing regulations, promoting transparency, accountability, and the overall well-being of residents.

Form LIC 311D provides a comprehensive list of the forms and records that family child care home providers in California must maintain. The form includes essential documents such as emergency contact information, attendance records, health and medical records, authorization forms, permission slips, and other relevant records specific to operating a family child care home. By utilizing this form, family child care home providers ensure compliance with licensing requirements, maintain accurate records, and promote the well-being and safety of the children in their care.

Form LIC 311C outlines the records that must be maintained at adult residential facilities in California. The form provides a comprehensive list of the required records, including resident admission records, service plans, medication records, incident reports, financial records, and other relevant documentation. By utilizing this form, adult residential facility operators ensure the proper maintenance and organization of records in compliance with licensing standards, promoting transparency, accountability, and the overall well-being of residents.

Form LIC 184C is a notification form utilized by the California Department of Social Services (CDSS) to notify child care center applicants about incomplete application submissions prior to issuing a 30-day Notice of Intent to Deny (NOIA). The form identifies the specific areas or documentation that are missing or incomplete, providing applicants with an opportunity to address these deficiencies within a specified timeframe. This form ensures transparency and allows applicants to complete their application before further action is taken.

Form LIC 281E is an application form used by individuals or organizations applying for a license to operate a short-term residential therapeutic program in California. The form is accompanied by a supporting documentation checklist that outlines the required documents and materials to be submitted along with the application.

Form LIC 311B specifies the records that must be maintained by group homes in California. The form provides a detailed list of the required records, including resident admission records, progress notes, medical records, incident reports, financial records, and other pertinent documentation. By utilizing this form, group home operators ensure the proper maintenance and organization of records in accordance with licensing requirements, facilitating efficient operations and compliance with applicable regulations.

Form LIC 311A outlines the specific records that must be maintained at child care centers, infant centers, school-age centers, and child care centers for mildly ill children in California. It provides a comprehensive list of the required records, including enrollment records, attendance records, health and medical records, emergency contact information, and other relevant documents necessary for operating a licensed child care facility.

Form LIC 309 is used to provide detailed information about the administrative organization and structure of a licensed facility in California. The form is completed by the facility operator or licensee, and it includes information such as the organizational chart, key personnel roles, responsibilities, and contact details. By utilizing this form, the California Department of Social Services (CDSS) gains insight into the administrative framework of the facility, facilitating effective communication, and ensuring compliance with licensing requirements.

Form LIC 308 is used to designate an individual within a facility who will be responsible for managing and overseeing compliance with licensing requirements and regulations. The form is completed by the facility operator or licensee to identify the designated responsible person and their contact information. By utilizing this form, the California Department of Social Services (CDSS) can establish clear lines of responsibility and ensure that an accountable individual is designated for compliance purposes within the licensed facility.