Form LIC 9263. Form 1-1: Resident Population - California

Form LIC 9263 is used in California by care facilities to report and track the resident population within their facility. This form is completed on an annual basis by the facility operator or administrator.

The form consists of sections that require information about the facility, including its name, address, license number, and the reporting period. The main part of the form focuses on gathering data about the resident population, including the total number of residents, their gender distribution, age groups, and any special populations or conditions present in the facility. Important fields include the total count of residents in different categories and any relevant remarks or explanations regarding the resident population.

An application example of this form would involve a care facility using Form LIC 9263 to report the resident population to the California Department of Social Services. The facility operator or administrator would fill out the form based on the number and characteristics of the residents residing in the facility during the reporting period. By completing this form, care facilities provide important demographic information to regulatory authorities and ensure compliance with reporting requirements.

Related forms: A related form is Form LIC 9099, Facility Information Questionnaire - California. While Form LIC 9263 focuses specifically on reporting the resident population, Form LIC 9099 is used to collect comprehensive information about the care facility itself, including details about its ownership, physical features, services provided, staffing, and policies. The main difference lies in the scope and focus of each form, with Form LIC 9263 focusing on gathering data related to the resident population, while Form LIC 9099 provides a more extensive overview of the care facility as a whole.