Form LIC 301B. Reference Request - Long-Term Care Ombudsman Program - California

Form LIC 301B is used in California for reference requests related to the Long-Term Care Ombudsman Program. Its main purpose is to collect information and feedback from references regarding the suitability and qualifications of individuals applying for roles in the program.

The form consists of sections where the requester provides contact information for the reference, relationship to the applicant, questions or prompts for the reference to respond to, and any additional details relevant to assessing the applicant's suitability for the Long-Term Care Ombudsman Program. It may also include a declaration section where the reference confirms the accuracy of their responses.

Important fields on this form include accurate contact information for the reference, clear and specific questions or prompts related to the applicant's skills, experience, and character, and proper documentation of the reference's consent to provide feedback. It is crucial to consider the relevance of the reference's relationship to the applicant and their ability to provide meaningful insights when selecting references and completing the form.

Application Example: When evaluating individuals for roles within the Long-Term Care Ombudsman Program in California, reference requests using Form LIC 301B can be sent to individuals who have worked closely with the applicants, such as colleagues, supervisors, or professionals in the long-term care industry. The collected references can help assess the applicant's abilities to advocate for residents' rights and ensure quality care in long-term care facilities.

Related Forms: There are no specific related forms mentioned for Form LIC 301B. However, other reference request forms may be used for different types of programs or roles within the California Department of Social Services.