Form LIC 9241. Entrance Checklist Adult Care Facilities - California
Form LIC 9241 is used in California by adult care facilities to document and track the process of admitting an individual into their facility. This form is completed by facility personnel when accepting residents for care and support.
Form LIC 9242. Entrance Checklist Residential Care Facilities For The Elderly - California
Form LIC 9242 is used in California by residential care facilities for the elderly (RCFE) to document and track the process of admitting an elderly individual into their facility. This form is completed by RCFE personnel when accepting residents for care and support.
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.
Form LIC 9264. Form 1-2: Annual Provider Fee - California
Form LIC 9264 is used in California by care facilities to calculate and report the annual provider fee owed to the California Department of Social Services. This form is completed on an annual basis by the facility operator or administrator.
Form LIC 9265. Form 5-1: Long-Term Debt Incurred In A Prior Year (Including Balloon Debt) - California
Form LIC 9265 is used in California by care facilities to report and provide details about long-term debt incurred in a prior year. This form is completed on an annual basis by the facility operator or administrator.
Form LIC 9266. Form 5-2: Long-Term Debt Incurred During Fiscal Year (Including Balloon Debt) - California
Form LIC 9266 is used in California by care facilities to report and provide details about long-term debt incurred during the fiscal year. This form is completed on an annual basis by the facility operator or administrator.
Form LIC 9267. Form 5-3: Calculation Of Long-Term Debt Reserve Amount - California
Form LIC 9267 is used in California by care facilities to calculate and report the long-term debt reserve amount. This form is completed on an annual basis by the facility operator or administrator.
Form LIC 9268. Form 5-4: Calculation Of Net Operating Expenses - California
Form LIC 9268 is used in California by care facilities to calculate and report the net operating expenses. This form is completed on an annual basis by the facility operator or administrator.
Form LIC 9269. Form 5-5: Annual Reserve Certification - California
Form LIC 9269 is used in California by care facilities to certify their annual reserves. This form is completed on an annual basis by the facility operator or administrator.
Form LIC 9270. Form 7-1: Report On CCRC Monthly Care Fees - California
Form LIC 9270 is used in California by Continuing Care Retirement Communities (CCRCs) to report monthly care fees. This form is completed on a monthly basis by the CCRC operator or administrator.