California Code of Regulations › Title 22 - Social Security › Division 6 - Licensing of Community Care Facilities › Chapter 8 - Residential Care Facilities for the Elderly (RCFE) › Article 1 - Definitions and Forms › Section 87102 - Descriptions of Forms

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
The forms specified in subsections (j) through
					 (
l
) only apply to this chapter, Chapter 8 (Residential Care
					 Facilities for the Elderly). The forms specified in subsections (a) through (i)
					 also apply to the regulations in Title 22, Division 6, Chapters 5 (Group Homes)
					 and 6 (Adult Residential Facilities). All forms in this section are
					 incorporated, in their entirety, by reference.
(a) LIC 9139 (01/16) -- Renewal of Continuing
				  Education Course Approval, Administrator Certification Program.
(b) LIC 9140 (01/16) -- Request for Course
				  Approval, Administrator Certification Program.
(c) LIC 9140A (01/16) -- Request to Add or
				  Replace Instructor, Administrator Certification Program.
(d) LIC 9141 (01/16) -- Vendor
				  Application/Renewal, Administrator Certification Program.
(e) LIC 9142A (01/16) -- Roster of
				  Participants -- for Vendor Use Only, Administrator Certification
				  Program.
(f) LIC 9142B (01/16) --
				  Roster of Participants -- for Exam Proctoring Only, Administrator Certification
				  Program.
(g) LIC 9163 (3/11) --
				  Request for Live Scan Service -- Community Care Licensing.
(h) LIC 508 (7/15) Criminal Record
				  Statement.
(i) LIC 9214 (01/16) --
				  Application for Administrator Certification, Administrator Certification
				  Program.
(j) PUB 325 (3/12) -- Your
				  Right To Make Decisions About Medical Treatment.
(k) Core of Knowledge Training Standard
				  (01/16) -- RCFE 80-Hour Initial Certification.
(l) PUB 475 (10/18) -- Residential Care
				  Facility for the Elderly (RCFE) Complaint Poster.
1. New
					 section filed 3-12-2001; operative 3-12-2001 pursuant to Government Code
					 section
					 11343.4
					 (Register 2001, No. 11).
2. New subsection (d) and subsection
					 relettering filed 9-24-2001; operative 9-24-2001 pursuant to Government Code
					 section
					 11343.4
					 (Register 2001, No. 39).
3. Change without regulatory effect
					 amending subsections (a)-(c) filed 11-8-2001 pursuant to section
					 100, title 1, California Code of
					 Regulations (Register 2001, No. 45).
4. Amendment of subsection (e)
					 filed 2-21-2002; operative 2-21-2002 (Register 2002, No. 8).
5.
					 Change without regulatory effect amending section heading and NOTE filed
					 3-5-2008 pursuant to section
					 100, title 1, California Code of
					 Regulations (Register 2008, No. 10).
6. Change without regulatory
					 effect moving article 2 heading from preceding section
					 87102 to preceding section
					 87105 filed 10-28-2008 pursuant to
					 section 100, title 1, California Code of
					 Regulations (Register 2008, No. 44).
7. Amendment of subsection (d)
					 filed 4-7-2015; operative 7-1-2015 (Register 2015, No. 15).
8.
					 Amendment of section and NOTE filed 12-30-2015; operative 1-1-2016 pursuant to
					 Government Code section
					 11343.4(b)(3)
					 (Register 2016, No. 1).
9. Amendment of first paragraph, new
					 subsection (l) and amendment of NOTE filed 8-24-2018; operative 10-1-2018
					 (Register 2018, No. 34).
Note: Authority cited: Sections
						1530,
						1569.616(i)(1)
						and
						1569.30,
						Health and Safety Code. Reference: Sections
						1522.41,
						1562.3,
						1569.267,
						1569.269,
						1569.33
						and
						1569.616,
						Health and Safety Code.