Social Security

LIC 401 is a monthly operating statement form issued by the California Social Services department for Family Child Care Homes in California. The main purpose of this form is to collect financial information and ensure the ongoing compliance of Family Child Care Homes with all necessary regulations and requirements.

The form consists of several parts that must be completed in full, including a summary of income and expenses, information about the number and ages of children in care, and details about any additional income sources or expenses.

LIC 279A is a license application form and set of instructions issued by the California Social Services department for individuals or groups who wish to establish a Family Child Care Home in California. The main purpose of this form is to collect relevant information from applicants and ensure compliance with all necessary regulations and requirements.

The LIC 9275 form is an external water sampler self-certification form used by the California Social Services agency. The main purpose of this form is to certify that a water sample has been collected in compliance with state regulations and to provide documentation of the sampling process.

LIC 621 is a form used in the state of California by social service agencies to document and protect the personal property and valuables of clients or residents who are receiving care or services. The primary purpose of this form is to provide a detailed inventory of personal belongings and assets to ensure their safekeeping while under the care of social service agencies.

The LIC 9283 form is a crucial document required by California Social Services for Adult Day Programs. The main purpose of this form is to provide an Infection Control Plan that outlines the steps and measures taken by the program to prevent and control infectious diseases.

The Emergency Disaster Plan for Adult Day Programs, Adult Residential Facilities, Residential Care Facilities for the Chronically Ill and Social Rehabilitation Facilities is a form provided by the California Department of Social Services. The main purpose of the form is to ensure that the licensee has an emergency disaster plan in place in case of any unforeseen natural disasters or emergencies.

LIC 605A is a form used to release client/resident medical information by the California Department of Social Services, Community Care Licensing. The primary purpose of this form is to obtain consent from the client or their authorized representative to release their medical information to specified individuals or entities.

Form LIC 601 is a mandatory document required by the California Department of Social Services, Health and Human Services Agency's Community Care Licensing Division. The primary purpose of this form is to gather identification and emergency information on every person admitted to a community care facility in California.

Form LIC 215 is a crucial form used by the California Department of Social Services' Community Care Licensing Division to collect applicant information for various social services programs in California.

The main purpose of this form is to gather personal and financial information about individuals who are seeking social services benefits such as CalWORKs, Medi-Cal, and CalFresh. The form consists of several sections covering different aspects of the applicant's background, including personal details, household members, income and expenses, assets and debts, and medical expenses.

Form LIC 125 is a mandatory checklist required by the California Department of Social Services, Health and Human Services Agency for child care centers. The primary purpose of this form is to ensure that all necessary requirements are met before admitting a child to a licensed child care center.