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state of california - health and human services agency california department of social services . physician's report for residential care facilities for the elderly (rcfe) i. facility information (to be completed by the licensee/designee) 1. name of facility 2. telephone ( ) 3. address . city . zip code . 4. licensee’s name . 5. telephone ( ) 6.
LICENSEE MUST REPORT THE DEATH OF A CLIENT OF ANY CAUSE, REGARDLESS OF WHERE THE DEATH OCCURRED. INSTRUCTIONS : NOTIFY LICENSING AGENCY, PLACEMENT AGENCY AND RESPONSIBLE PERSONS, IF ANY, BY NEXT WORKING DAY. SUBMIT WRITTEN REPORT WITHIN 7 DAYS OF OCCURRENCE. RETAIN COPY OF REPORT IN CLIENT’S FILE. MEDICAL TREATMENT NECESSARY?
state of california - health and human services agency california department of social services community care licensing division death report licensee must report the death of a client of any cause, regardless of where the death occurred. instructions : notify licensing agency, placement agency and responsible persons, if any, by next working day.
LIC 9265 (6/21) – Form 5-1: Long-Term Debt Incurred In A Prior Year (Including Balloon Debt) LIC 9266 (3/21) – Form 5-2: Long-Term Debt Incurred During Fiscal Year (Including Balloon Debt) LIC 9267 (3/21) – Form 5-3: Calculation Of Long-Term Debt Reserve Amount; LIC 9268 (6/21) – Form 5-4: Calculation Of Net Operating Expenses
Title: LIC 602A.pdf Author: ecotrials Created Date: 4/14/2020 1:20:09 PM
1 sie 2011 · Form LIC 602A, Physician's Report for Residential Care Facilities for the Elderly (RCFE), is a form used to inform a residential care facility about the physical and mental condition of the resident or prospective resident.
state of california - health and human services agency california department of social services physician's report for residential care facilities for the elderly (rcfe) i. facility information (to be completed by the licensee/designee) 1. name of facility 2. telephone ( ) 3. address city zip code 4. licensee’s name 5. telephone 6.
