Form LIC 00. Conversion to Resource Family: Release of Information - California

Form LIC 00 is used in California for the conversion to a resource family. It serves as a release of information, authorizing the exchange of relevant information between the applicant and the licensing agency. The main purpose of this form is to grant permission for the sharing of information necessary for the evaluation and approval process.

The form consists of sections where the applicant provides their personal information, including name, address, contact details, and any relevant identification numbers. There are specific fields to indicate consent for the release of various types of information, such as medical records and employment history.

It is important for the applicant to carefully review and fill out the form, ensuring that they have provided accurate information and have given consent for the appropriate types of information to be shared. This form involves two parties: the applicant seeking conversion to a resource family and the licensing agency responsible for evaluating the application.

Application Example: An individual who is currently a licensed foster care provider in California and wishes to convert their license to become a resource family will need to complete Form LIC 00. By filling out this form and authorizing the release of necessary information, the applicant initiates the evaluation process for the conversion.

Related Forms: Form LIC 00A, the Conversion - Resource Family Application, is closely related to Form LIC 00. While Form LIC 00 focuses on granting permission for the release of information, Form LIC 00A is the actual application form for the conversion process. Both forms are often used together, with Form LIC 00 being completed first to allow the sharing of information, followed by the completion of Form LIC 00A to formally apply for conversion.