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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.
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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. submit written report within 7 days of occurrence. retain copy of report in client’s file. name of facility facility file ...
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?
This file is designed for reporting client deaths to the California Department of Social Services. It contains essential information required for proper documentation and follow-up. Users must fill out this form accurately to ensure compliance with state regulations.
STATE OF CALIFORNIA – HEALTH AND HUMAN SERVICES AGENCY CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING PHYSICIAN’S REPORT FOR COMMUNITY CARE FACILITIES For Resident/Client Of, Or Applicants For Admission To, Community Care Facilities (CCF). ... LIC 602 (7/11) PAGE 3 OF 3. Title: LIC602.pdF
Title: LIC 602A.pdf Author: ecotrials Created Date: 4/14/2020 1:20:09 PM
