Form LIC 604. Admission Agreement Guide For Residential Facilities - California

Form LIC 604 is used in California by residential facilities to provide an admission agreement guide to individuals seeking residency. The main purpose of this form is to ensure transparency and clarity regarding the terms, conditions, and rights of residents upon admission.

The form consists of sections that outline important information such as the facility's name, address, contact details, and licensing information. It also includes details about the services provided, resident rights and responsibilities, fees and payment terms, rules and regulations, and procedures for addressing grievances or disputes. The form may include spaces for the signature of the resident or their representative and the date of agreement.

Important fields on this form include accurately describing the services offered, clearly stating the rights and responsibilities of residents, providing details about fees and payment arrangements, and including procedures for conflict resolution. It is essential for the residential facility to ensure that the admission agreement is fair, comprehensive, and complies with relevant regulations to protect the rights and well-being of residents.

Application Example: A residential care facility in California admits a new resident. Form LIC 604 would be provided to the resident or their representative as a guide to understand the terms and conditions of residency. By reviewing and signing the form, the resident acknowledges their understanding of the agreement, promoting clear communication between the facility and the resident.

Related Forms: There are no specific related forms mentioned for Form LIC 604. However, other documents such as resident contracts, financial disclosure forms, and consent forms may be used alongside this form to establish a comprehensive agreement between the residential facility and the resident.