WebGUIDELINES FOR COMMUNITY CARE LICENSING (CCLD) APPLICANTS WHO USE A LIVE SCAN SITE (CCLD or DOJ SITE) FOR FINGERPRINTING Instructions for the LIC 9163 1. Originating Response Indicator (ORI): Preprinted 2. Working Title: Check the appropriate box 3. Authorized Applicant Type: Indicate the facility type where you will be … WebUse the Add New button. Then upload your file to the system from your device, importing it from internal mail, the cloud, or by adding its URL. Edit lic 602 form. Rearrange and rotate pages, insert new and alter existing texts, add new objects, and take advantage of other helpful tools. Click Done to apply changes and return to your Dashboard.
RECORDS TO BE MAINTAINED BY THE FACILITY – GROUP …
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Form CCL.032 Request for Licensing Amendment - Kansas
WebYour completion of this form will serve to document your patient’s current ability to determine his/her own need for these medications. As a licensed care provider, it is my responsibility to monitor your patient’s continued ability to WebApr 4, 2024 · Welcome to the Community Care Licensing Division. We serve the most vulnerable people of California and our mission is to promote the health, safety, and … Please do not provide personal information that is not requested. Any fields in the … Have a Heart, Be a Star, Help Our Kids. The Department of Motor Vehicles offers … Refer to PIN 21-11-CCLD for additional information about fee changes. About … If you have problems accessing them, please send your comments to … Community Care Licensing Adult and Senior Care Program 744 P Street, MS … NOTE: Prior to November 2016, CCLD information currently being … CCLD Complaint Hotline File a Complaint 1-844-LET-US-NO. Adult and Senior Care … Community Care Licensing Adult and Senior Care Program 744 P Street, MS … Contact Us. Community Care Licensing Division Statewide Children's … The Community Care Licensing Division (CCLD) is focusing its efforts on three … WebAug 19, 2024 · CCLD Regional Office, 2525 NATOMAS PARK DR. STE.270 SACRAMENTO, CA 95833: FACILITY NAME: SERRANO MANOR: ... I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: ... Facility shall have R1's LIC 602 … kathy from diff\u0027rent strokes