Form LIC 9102TV. Advisory Notes - Technical Violation - California

Form LIC 9102TV is used in California by the Department of Social Services to notify licensees or applicants for licensed facilities or programs about technical violations identified during inspections or investigations. The main purpose of this form is to inform individuals or entities about specific areas where they are not in compliance with regulatory requirements.

The form consists of sections where the department outlines the technical violations and provides explanations or references to relevant regulations or standards. The form may also include instructions on how to address the violations, obtain compliance, or request additional clarification. It may have a section for the licensee or applicant to acknowledge receipt of the advisory notes.

Important fields on this form include clearly describing the identified technical violations, providing references to the applicable regulations or standards, and offering guidance on how to rectify the issues and achieve compliance. It is crucial for the licensee or applicant to take prompt action to address the violations and ensure ongoing compliance with regulatory requirements.

Application Example: During an inspection of a residential care facility in California, the Department of Social Services identifies a technical violation related to medication storage. The facility receives Form LIC 9102TV, which explains the violation, references the relevant regulation governing medication storage, and provides instructions on how to correct the issue. By addressing the technical violation promptly, the facility can maintain regulatory compliance and ensure the safety and well-being of its residents.