Form LIC 613C-2. Personal Rights Of Residents In Privately Operated Residential Care Facilities For The Elderly
The LIC 613C-2 form outlines the personal rights of residents in privately operated Residential Care Facilities for the Elderly (RCFE) in California, and provides complaint procedures for residents and their responsible persons.
Form LIC 604A. Admission Agreement For Residential Care Facilities For The Elderly
The LIC 604A admission agreement is a legal document that must be completed by a residential care facility for the elderly when admitting a resident.
Form LIC 603A. Resident Appraisal
The Resident Appraisal form (LIC 603A) is a crucial component of the application process for prospective residents of Residential Care Facilities for the Elderly.
Form LIC 622A. Medication Administration Record (MAR)
The LIC 622A form, also known as the Medication Administration Record (MAR), is a crucial document used in licensed community care facilities and foster/certified/resource family agencies to record medication self-administration by children.
Form LIC 624A. Death Report
The LIC 624A Death Report is a mandatory form that licensees must complete and submit when a client dies, regardless of the cause and location of death. The purpose of this form is to notify the licensing agency, placement agency, and responsible parties (if any) about the client's death.
Form LIC 508 O-O-S. Out-Of-State Disclosure
The LIC 508 O-O-S is a form that requires disclosure of out-of-state residence for the past five years. It is intended for licensees seeking approval to work, be present at or licensed facilities, certified family homes or home of a resource family.
Form LIC 9020A. Register Of Facility Residents - Residential Care Facilities For The Elderly
The LIC 9020A is a form used to register residents in residential care facilities for the elderly. The main purpose of this form is to keep a record of all the residents who reside in these facilities.
DA Form 7809. Summary of Care by Non-Military Medical Provider
The DA Form 7809, Summary of Care by Non-Military Medical Provider, is a document used to provide a summary of medical care provided to military personnel by non-military healthcare providers.
DA Form 7531. Checklist and Tracking Document for Financial Liability Investigations of Property Loss
The DA Form 7531 is a Checklist and Tracking Document used to investigate financial liability for the loss of government property.
DA Form 5123. In- and Out- Processing Records Checklist
The DA Form 5123, also known as the In- and Out-Processing Records Checklist, is a document used by the United States Army to record and track personnel entering and leaving a military installation.