Form LIC 9240. Entrance Checklist Small Family Home - California

Form LIC 9240 is used in California by small family homes to document and track the process of admitting an individual or individuals into their home. This form is completed by small family home operators when accepting residents for care and support.

The form consists of sections that require information about the individual(s) being admitted, including personal details, medical history, support needs, and any immediate safety concerns. Important fields include the resident's name, date of birth, health conditions, medications, allergies, and emergency contact information. Accurate completion of this form ensures that relevant information is gathered to provide appropriate care and support within the small family home setting.

An application example of this form would involve a small family home using Form LIC 9240 when admitting a resident into their home. The small family home operator would gather the necessary information, conduct an assessment of the resident's needs and preferences, and develop a plan for their care and integration into the home. By completing this form, small family homes can maintain accurate records and provide personalized care in a family-like environment.

Alternative forms: An alternative form to consider is the Form LIC 9108, Application for a Family Child Care Home License - California. While Form LIC 9240 focuses on entrance information for small family homes, Form LIC 9108 is used for the application and licensing process of family child care homes. The main difference lies in the type of care provided, with small family homes offering residential care for adults or elderly individuals, while family child care homes focus on providing child care services for children.