Form LIC 9242. Entrance Checklist Residential Care Facilities For The Elderly - California

Form LIC 9242 is used in California by residential care facilities for the elderly (RCFE) to document and track the process of admitting an elderly individual into their facility. This form is completed by RCFE personnel when accepting residents for care and support.

The form consists of sections that require information about the resident being admitted, including personal details, medical history, support needs, and any immediate safety concerns. Important fields include the resident's name, date of birth, diagnoses, 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 residential care facility.

An application example of this form would involve an RCFE using Form LIC 9242 when admitting an elderly resident into their facility. RCFE personnel would gather the necessary information, conduct assessments of the resident's physical and cognitive abilities, and develop a personalized care plan. By completing this form, residential care facilities for the elderly can maintain accurate records and provide specialized care and support to elderly individuals in need.

Alternative forms: An alternative form to consider is the Form LIC 9107, Residential Care Facility for the Elderly Application - California. While Form LIC 9242 focuses on entrance information for residential care facilities for the elderly, Form LIC 9107 is used specifically for the application and licensing process of residential care facilities for the elderly (RCFE). The main difference lies in the purpose and content of each form. Form LIC 9242 is used for documenting the entrance checklist and admission information of individual residents, while Form LIC 9107 is focused on the overall application and licensing process for RCFEs.