Form LIC 9123. FacilityВ Inspection Checklist - Residential Care Facility For The Elderly - California
Form LIC 9123 is a Facility Inspection Checklist designed specifically for Residential Care Facilities for the Elderly (RCFE) in California.
Form LIC 9128. Foster Family Agency Program Statement - California
Form LIC 9128 is a Foster Family Agency Program Statement used in California. This form is utilized by foster family agencies to provide detailed information about their programs, services, and policies to the California Department of Social Services.
Form LIC 9139. Renewal Of Continuing Education Course Approval - Administrator Certification Program - California
Form LIC 9139 is used for the renewal of Continuing Education Course Approval in the Administrator Certification Program in California.
Form LIC 9140. Request For Course Approval - Administrator Certification Program - California
Form LIC 9140 is used to request course approval in the Administrator Certification Program in California. This form is completed by course providers who intend to offer new educational courses for administrators in facilities regulated by the California Department of Social Services.
Form LIC 9140A. Request to Add or Replace Instructor - California
Form LIC 9140A is used in California to request the addition or replacement of an instructor in a course approved under the Administrator Certification Program.
Form LIC 9141. Vendor Application/Renewal - Administrator Certification Program - California
Form LIC 9141 is used for the application or renewal of vendor status in California's Administrator Certification Program.
Form LIC 9142A. Roster of Participants - California
Form LIC 9142A is used to create a roster of participants for courses approved under the Administrator Certification Program in California. This form is completed by course providers to document the attendance and completion of approved courses by participants.
Form LIC 9163. Request Live Scan Service - Community Care Licensing - California
Form LIC 9163 is used in California to request Live Scan services for individuals associated with Community Care Licensing. This form is completed by individuals who require background checks as part of their involvement in Community Care Licensing programs.
Form LIC 9163B. Request Live Scan Service - Long Term Care OMBUDSMAN - California
Form LIC 9163B is used in California to request Live Scan services for individuals involved with the Long Term Care Ombudsman program. This form is completed by individuals who require background checks as part of their roles within the Long Term Care Ombudsman program.
Form LIC 9165. Board Of Director Statement - California
Form LIC 9165 is used in California for individuals seeking approval as board members for licensed facilities regulated by the California Department of Social Services.