Lic 508 2011 form-2025

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2015 4.8 Satisfied (86 Votes)
2011 4.4 Satisfied (511 Votes)
2003 4.1 Satisfied (64 Votes)
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CALIFORNIA DEPARTMENT OF SOCIAL SERVICES. PERSONNEL REPORT. INSTRUCTIONS: This form is intended for keeping a current roster of all the facility personnel, other adults and licensees residing in the facility, including backup persons, volunteers and licensee if administrator/director.
California prohibits CRAs from reporting convictions older than seven years under Cal. Civ. Code 1786.18(a)(7). This law also prohibits CRAs from reporting arrests not leading to convictions even if they occurred within the last seven years, but pending cases can be reported.
CRIMINAL RECORD STATEMENT OUT-OF-STATE DISCLOSURE. LIC 508 (7/21) Page 1 of 5 State law requires that persons associated with licensed care facilities, Home Care Aide Registry or TrustLine Registry applicants be fingerprinted and disclose any conviction.
To receive a copy of YOUR criminal history record, individuals must submit fingerprint images, pay a $25 processing fee to the DOJ, and follow the instructions below. You may be eligible to apply for a fee waiver to cover the DOJ processing fees. See Apply for a Fee Waiver.
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