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 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.
Form LIC 9182. Criminal Background Clearance Transfer Request - California
Form LIC 9182 is used in California to request the transfer of a criminal background clearance from one facility or program to another within the scope of Community Care Licensing.
Form LIC 9200. Pre-Licensing Facility Evaluation Checklist - California
Form LIC 9200 is a pre-licensing facility evaluation checklist used in California to assess the readiness of a facility for obtaining a license from Community Care Licensing. This form is completed by individuals or organizations seeking to establish a new facility and obtain a license.
Form LIC 9240. Entrance Checklist Small Family Home - California
Form LIC 9240 is used in California by small family homes to document and track the process of admitting an individual or individuals into their home. This form is completed by small family home operators when accepting residents for care and support.