Form LIC 309. (PUBLIC) - Administrative Organization - California

Form LIC 309 is used in California to provide administrative organization information related to a licensed facility or program. Its main purpose is to gather details about the organizational structure and key personnel involved in the operation of the facility.

The form consists of sections where the licensee provides information about the facility, such as its name and address, and describes the administrative organization, including positions, roles, and responsibilities. It may also include contact information for key personnel and any additional documentation required to support the organizational structure.

Important fields on this form include accurately describing the administrative organization of the facility, providing clear and concise information about positions and roles, and ensuring that contact information for key personnel is up-to-date. It is important to consider the specific requirements and guidelines provided by the State Department of Social Services when completing the form.

Application Example: For a group home in California, Form LIC 309 would be used to outline the administrative structure, such as the executive director, program manager, case managers, and support staff. By completing the form, the licensee provides transparency regarding the facility's administrative organization, enabling effective communication, accountability, and decision-making.

Related Forms: There are no specific related forms mentioned for Form LIC 309. However, other licensing or organizational documents may be required by the State Department of Social Services to ensure compliance and proper functioning of licensed facilities or programs.