Lic 9098-2026

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  1. Click ‘Get Form’ to open the LIC 9098 in the editor.
  2. Complete the top portion of the form, including the facility name and number, as well as the licensing evaluator's details.
  3. In the DEFICIENCY(IES) COLUMN, list each regulation section number that was violated according to your Licensing Report.
  4. In the PROOF OF CORRECTION COLUMN, check the appropriate box for your proof of correction, such as receipts or photos.
  5. Under DATE CORRECTED, enter the date when each deficiency was corrected. This should only be filled out after corrections are made.
  6. Attach any documentary evidence of corrections and ensure you complete and sign the form before returning it to the licensing agency by the specified due dates.

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I/We hereby declare that I/We have not served on any Office of the Life Insurance Corporation of India any Notice of assignment or reassignment in respect of the above POLICY/ POLICIES except those, if any already Registered by the Life Insurance Corporation of India or the Insurer who issued the above POLICY/POLICIES
LIC 308 is known as Designation of Facility Responsibility. This document is widely used in licensed facilities in California. The form was created by the California Department of Social Services Community Care Licensing. It is required whenever you want to send the authorized person that represents the whole facility.
The LIC 9108 California document is required by the mandated reporter, the administrator, licensee, or employee that works in a child care institution, visits foster parents houses, or received complaints from the witnesses of child abuse in the family.

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The California Department of Social Services (CDSS) requires child care facilities to record employees acknowledgment of having received an Employee Rights document using the Notice: Employee Rights (LIC 9052) form.

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