Form LIC 421D (ASC) is used in California to assess civil penalties against licensed facilities or programs in cases involving death, serious bodily injury, or physical abuse. The main purpose of this form is to document and enforce penalties for severe incidents that jeopardize the health, safety, or well-being of individuals under care.
Form LIC 421CC is used in California to assess civil penalties related to child care services in licensed facilities or programs. The main purpose of this form is to document and enforce penalties for non-compliance with regulations pertaining to child care.
Form LIC 421BG is used in California to assess civil penalties related to caregiver background checks in licensed facilities or programs. The main purpose of this form is to document and enforce penalties for non-compliance with background check requirements for caregivers.
Form LIC 421A is used in California to assess civil penalties against unlicensed facilities that operate without proper licensing or certification. The main purpose of this form is to document and enforce penalties for non-compliance with licensing requirements.
Form LIC 420 is used in California to provide budget information for licensed facilities or programs. The main purpose of this form is to outline the projected income and expenses for a specific period, typically on an annual basis.
Form LIC 406 is used in California to maintain a record of client's or resident's cash transactions within licensed facilities or programs. The main purpose of this form is to track and document the flow of cash related to the client's or resident's personal funds.
Form LIC 405 is used in California to maintain a record of a client's or resident's safeguarded cash resources within licensed facilities or programs. The main purpose of this form is to track and document any cash resources entrusted to the facility for safekeeping on behalf of the client or resident.
This form, Form LIC 12, is used in California as an Alternative Plan (DAP) for the resource family approval process. Its main purpose is to outline an alternative plan for meeting specific requirements or standards when the standard approval process cannot be followed.
The form consists of sections where the applicant or resource family specifies the areas in which they are unable to meet the standard requirements and proposes an alternative plan to address those areas. It includes details about the alternative plan, the steps to be taken, and the timeline for completion.
Form LIC 404 is used in California to release and verify financial information provided by an individual or organization. The main purpose of this form is to obtain consent from the individual or organization to release their financial information and verify its accuracy.
Form LIC 403A is used in California as a supplemental schedule to the balance sheet for licensed facilities or programs. The main purpose of this form is to provide additional details and breakdowns of specific assets, liabilities, or equity accounts mentioned in the balance sheet.
