Form LIC 9224. Acknowledgement Of Receipt Of Licensing Reports - California

Form LIC 9224 is used in California to acknowledge the receipt of licensing reports by licensed facilities regulated by Community Care Licensing. This form is completed by facility administrators or authorized personnel to confirm that they have received and reviewed licensing reports provided by the licensing agency.

The form consists of sections that require information about the facility, the report being acknowledged, and a statement of confirmation. Important fields include the facility's name, identification numbers related to the report, and the signature of the individual acknowledging receipt. Accurate and timely completion of this form is essential to demonstrate compliance with reporting requirements and ensure that licensing reports are properly received and reviewed.

An application example of this form would involve a facility administrator or authorized personnel completing Form LIC 9224 upon receiving a licensing report from the licensing agency. They would provide the necessary information, such as the facility's name and identification numbers, and sign the form to confirm receipt. By promptly acknowledging the receipt of licensing reports through this form, licensed facilities can fulfill their responsibilities and maintain compliance with regulatory requirements.