Form LIC 808. Plan For Epidemic Outbreak Specific to COVID - 19 Mitigation Plan Report - California

Form LIC 808 is used in California by various licensed facilities to develop and document their mitigation plan specifically for an epidemic outbreak, with a focus on COVID-19. The main purpose of this form is to ensure that facilities have a comprehensive plan in place to prevent the spread of COVID-19 and protect the health and safety of staff, residents, and other individuals within the facility.

The form consists of sections where the facility outlines their specific strategies and protocols for mitigating the risk of COVID-19 transmission. It includes information regarding infection control measures, screening procedures, personal protective equipment (PPE) usage, cleaning and disinfection protocols, communication plans, staff training, and contingency plans. The form may also require the facility to provide supporting documentation or evidence of implementation.

Important fields on this form include accurately documenting the facility's COVID-19 mitigation plan, ensuring it aligns with relevant guidelines and regulations, and providing detailed information on each aspect of the plan. It is crucial for facilities to regularly review and update this form to reflect changing circumstances and guidance related to COVID-19.

Application Example: A residential care facility in California is required to complete Form LIC 808 to develop and document their plan for mitigating the risk of COVID-19. The facility would outline their strategies for regular testing, vaccination requirements, isolation protocols for infected individuals, staff training on infection control practices, and other preventive measures. This form helps the facility demonstrate their commitment to safeguarding the health and well-being of residents and staff during the COVID-19 pandemic.