Form LIC 421A. Civil Penalty Assessment (Unlicensed Facility) - California
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 421BG. Civil Penalty Assessment - Caregiver Background Check - California
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 421CC. Civil Penalty Assessment - Child Care - California
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 421D (ASC). Civil Penalty Assessment - Death/Serious Bodily Injury/Physical Abuse (ASC) - California
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.
Form LIC 421D (CC). Civil Penalty Assessment - Death/Serious Injury/Physical Abuse (Child Care) - California
Form LIC 421D (CC) is used in California to assess civil penalties against licensed child care facilities or programs in cases involving death, serious injury, or physical abuse.
Form LIC 421D (CRP). Civil Penalty Assessment - Death/Serious Bodily Injury/Physical Abuse (CRP) - California
Form LIC 421D (CRP) is used in California to assess civil penalties against Community Care facilities (such as adult residential facilities and group homes) in cases involving death, serious bodily injury, or physical abuse.
Form LIC 421FC. Civil Penalty Assessment - Failure To Correct And Repeat Violations - California
Form LIC 421FC is used in California to assess civil penalties against licensed facilities or programs that have failed to correct violations or have repeated violations.
Form LIC 421IM. Civil Penalty Assessment - Immediate $500 And Repeat Violations - California
Form LIC 421IM is used in California to assess civil penalties against licensed facilities or programs for immediate violations and repeat offenses.
Form LIC 500. Personnel Report - California
Form LIC 500 is used in California to report personnel information for individuals working in licensed facilities or programs. The main purpose of this form is to ensure accurate documentation of the facility's staff members and their qualifications as required by licensing regulations.
Form LIC 507. Facilities Staff Work Schedule - California
Form LIC 507 is used in California to document the work schedules of staff members in licensed facilities or programs. The main purpose of this form is to ensure proper staffing levels and compliance with licensing regulations regarding staff-to-individual ratios.