Form LIC 9239. Entrance Checklist Group Home - California

Form LIC 9239 is a general entrance checklist form used in California by group homes to document and track the process of admitting an individual into their facility. This form is completed by group home personnel when welcoming a new resident.

The form consists of sections that require information about the individual being admitted, including personal details, background information, support needs, and any immediate safety concerns. Important fields include the individual's name, date of birth, previous living situation, reason for admission, and emergency contact information. Accurate completion of this form ensures that relevant information is gathered to provide appropriate care and support within the group home setting.

An application example of this form would involve a group home using Form LIC 9239 when admitting an individual into their facility. Group home personnel would gather the necessary information, conduct an initial assessment of the individual's needs, and develop a plan for their care and integration into the group home community. By completing this form, group homes can maintain accurate records and offer supportive living environments for individuals in need of residential care.

Related forms: A related form is Form LIC 9116, Daily Incident and Communication Log - California. While Form LIC 9239 captures entrance information for group homes, Form LIC 9116 focuses on documenting daily incidents and communication within the group home. The main difference lies in the purpose and content of each form, with Form LIC 9239 focusing on admission details and Form LIC 9116 addressing ongoing communication and incident reporting within the group home.