Form LIC 9239 CTF. Entrance Checklist Community Treatment Facility - California

Form LIC 9239 CTF is used in California by community treatment facilities to document and track the process of admitting an individual into their program. This form is completed by facility personnel when accepting an individual for community-based treatment and support.

The form consists of sections that require information about the individual being admitted, including personal details, medical history, treatment goals, and any specialized needs or considerations. Important fields include the individual's name, date of birth, diagnoses, medications, and emergency contact information. Accurate completion of this form helps ensure that relevant information is gathered to provide appropriate treatment and support services within the community treatment facility.

An application example of this form would involve a community treatment facility using Form LIC 9239 CTF when admitting an individual into their program. Facility personnel would gather the necessary information, conduct an assessment of the individual's treatment needs, and develop a personalized treatment plan. By completing this form, community treatment facilities can maintain accurate records and deliver targeted interventions to individuals seeking community-based treatment and support.

Alternative forms: An alternative form to consider is the Form LIC 9211, Application for Certification Community Care Facilities - California. While Form LIC 9239 CTF focuses on entrance information for community treatment facilities, Form LIC 9211 serves as the initial application form for organizations seeking certification to operate community care facilities. The main difference lies in the purpose and content of each form, with Form LIC 9239 CTF focusing on gathering essential admission information, whereas Form LIC 9211 addresses the certification process and organizational requirements for operating community care facilities.