Form LIC 313. Evidence Of Program Consultant - California

Form LIC 313 is used in California to provide evidence of program consultant services. The main purpose of this form is to document the engagement of a program consultant who provides expertise, guidance, and oversight to licensed facilities or programs.

The form consists of sections where the licensee provides information about the program consultant, such as their name, qualifications, and contact details. It may also include sections where the consultant's scope of work, objectives, and duration of services are described. Additionally, the form may require signatures from both the licensee and the program consultant to attest to the agreement.

Important fields on this form include accurately documenting the details of the program consultant, clearly outlining the scope of their work, and ensuring that both parties understand and agree to the terms. It is essential to consider the qualifications and experience of the program consultant and comply with any regulations or guidelines regarding their involvement when completing the form.

Application Example: A licensed substance abuse treatment facility in California engages a program consultant to provide clinical supervision and guidance to their staff. Form LIC 313 would be used to document the consultant's credentials, specify the areas of consultation, and outline the terms of the consulting agreement. By completing the form, the licensee establishes a formal arrangement with the program consultant, facilitating professional development and enhancing the quality of care provided at the facility.

Related Forms: There are no specific related forms mentioned for Form LIC 313. However, other documents and agreements related to consultant services may be required by the California Department of Social Services or other regulatory bodies.