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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING PREPLACEMENT APPRAISAL INFORMATION Admission - Residential Care Facilities NOTE This information may be obtained from the applicant or his/her authorized representative. Relatives social agency hospital or physician may assist the applicant in completing this form* This form is not a substitute for the Physician s Report LIC 602. An ambulatory person must be able to do the fo ...

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