Lic 9214-2026

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4.8 out of 5

104 votes

The document is an application form for Administrator Certification from the California Department of Social Services, specifically for individuals seeking to manage community care facilities. It outlines the application process, requirements for new and renewal applicants, and necessary documentation, including criminal record clearance and proof of training. The form includes sections for personal information, type of application, and certification declarations.

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Click ‘Get Form’ to open the lic 9214 in the editor.
Begin by selecting the type of application at the top of the form. Choose either 'New' or 'Renewal' and provide your certificate number and expiration date if applicable.
Next, indicate the type of program you are applying for by checking one box from options like ARF, RCFE, or STRTP.
Fill in your personal information in the Applicant Information section. Ensure that all fields such as name, address, and contact details are accurately completed.
Answer the questions regarding previous licenses and employment history. Be honest and thorough, as this information is crucial for your application.
For initial applicants, select when you would like your certificate to expire. If unsure, default to two years from issuance.
Finally, review all entered information for accuracy before signing and dating the application at the bottom.

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Versions	Form popularity	Fillable & printable
2019	4.8 Satisfied (104 Votes)
2016	4.3 Satisfied (167 Votes)
2016	4.2 Satisfied (55 Votes)
2012	4.3 Satisfied (121 Votes)
2006	4.3 Satisfied (57 Votes)

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