Form SSA-89 Authorization for the Social Security Administration (Ssa) to Release Social Security Number (Ssn) Verification
The procuring data from this form is used by the Social Security Administration (SSA) to allow a third party to establish a link between a person's name and a social security number. This requirement is mandatory.
Download this form, which is a medical certification submitted by a licensed health care professional to sanction the disabled, blind, or elderly access for services from the In-Home Supportive Services (IHSS) program.
File this form if you are the physician of the applicant for admission to a Community Care Facility and have a thorough knowledge of the patient's medical issues. The goal of this document is to check if the patient can continue their residential treatment at the facility.
This is form issued by the California Department of Social Services (CDSS). It is filed to keep a current list of the staff (including backup persons, volunteers, etc.) employed and residing on the facility.
This document is also known as the LIC injury report form. It is an application intended for daycare providers used to report unusual incidents to the appropriate California state organizations.
This form is used for determining if the child receiving annuitants from the Survival Benefit Plan or Reserve Component Survivor Benefit Plan is eligible to receive them after they turn eighteen.
Use this form if you are health care professional to keep track of non-psychotropic medications prescribed to a child. This four-page record sheet is often referred to as a drug chart.
File this document if you are an employee of a licensed community care facility or home care organization, and wish to apply for a transfer of your active criminal record from one state licensed facility to another.
Form LIC 602A Physician's Report for Residential Care Facilities for the Elderly (Rcfe) - California
Download this document to inform your residential care facility of care needs, diagnosis, and mental condition of an elderly person.
This form was issued and distributed by the California Department of Social Services Community Care Licensing Division. Use it for child care-related matters. The form description has explanations of parental rights related to the child care facilities, as well as a list of relevant documents.