Lic 610c 2026

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  1. Click ‘Get Form’ to open the lic 610c in the editor.
  2. Begin by entering the name and address of your facility in the designated fields at the top of the form.
  3. Fill in the administrator's details, including their name, contact number, and address. Ensure accuracy for effective communication during emergencies.
  4. In Section I, list assignments during an emergency. Specify titles, assignments, and names of staff responsible for each task. Use additional space if necessary.
  5. Proceed to Section II to input emergency contacts such as fire services, police, and hospitals. This information is crucial for quick access during a crisis.
  6. For Section III, indicate facility exit locations using a copy of your facility sketch (LIC 999) to ensure clear evacuation routes.
  7. Complete Sections IV through VIII by providing temporary relocation sites, utility shut-off locations, first aid kit location, and affirmation statement with your signature and date.

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References are to be completed on the Reference Request-Exemption form (LIC 301E).
EMERGENCY DISASTER PLAN FOR CHILD CARE CENTERS. Post a copy in a prominent location in facility, near telephone. Licensee is responsible for updating information as required.
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.
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.
Application for a Child Care Center License LIC 200A. Application For A Community Care Facility or Residential Care Facility For The Elderly License LIC 200.

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Form 602 is issued by the California Department of Social Services. The form was established as a way to help senior communities better understand the needs of potential residents in terms of medical assistance, nutritional needs, mental and physical capabilities and other care requirements.

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