Form LIC 809. Facility Evaluation Report - California

Form LIC 809 is used in California by licensed facilities to conduct and document regular evaluations of their operations and compliance with applicable regulations. The main purpose of this form is to assess the facility's overall compliance, identify areas for improvement, and ensure the health, safety, and well-being of individuals within the facility.

The form consists of sections where the facility evaluates various aspects of its operations, including physical environment, safety measures, staff qualifications and training, emergency preparedness, resident or client care, documentation practices, and adherence to relevant regulations. It may require the facility to provide supporting evidence or documentation for specific compliance items. The form may also include space for corrective action plans or recommendations for improvement.

Important fields on this form include accurately documenting the facility's evaluation findings, addressing any identified deficiencies, and outlining plans for corrective action. It is essential for facilities to regularly complete and review this form to maintain compliance, identify areas of improvement, and provide a safe and suitable environment for individuals in their care.

Application Example: A child care center in California completes Form LIC 809 to evaluate its compliance with licensing regulations. The center assesses aspects such as staff-child ratios, health and safety practices, staff qualifications, and emergency preparedness. Based on the evaluation findings, the center develops an action plan to address any identified deficiencies and improve the quality of care provided.