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What is the lic 500 form?

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.

What is the LIC 308 designation of facility responsibility?

LIC 308 - DESIGNATION OF FACILITY RESPONSIBILITY At least one individual must be designated as the authorized person of the facility to act in the licensees absence. A LICENSEE CANNOT DESIGNATE HIM OR HERSELF.

What is an LIC 503 form?

The LIC 503 is required by the California Department of Social Services as part of the application process to work in a Community Care facility. It is used during the hiring process to verify the health of the applicant. It requires completion and signature by a physician.

What is a LIC 508 form?

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.

How to fill out a health screening report?

How to fill out the California Health Screening Report for Facility Personnel? Enter your personal and facility details. Indicate the types of persons you serve. Fill in your work schedule. Have a physician evaluate your health. Sign and date the form.

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