Form LIC 622A, Medication Administration Record (MAR), is a document used to record and administer medications prescribed to a child. This specific form is suitable to record non-psychotropic medications only. It is considered a legal record of the medications administered to a child by the health care professional.
Alternate Names:
The LIC 622A Form is a state-specific document issued and used by the Community Care Licensing Division, a division of the California Department of Social Services (CDSS). The most recent version of the form was released by the department on June 1, 2017. You can find and download the up-to-date form through the link below.
TheLIC Medication Administration Record contains four pages in total. The first two contain the actual form, the rest include detailed filing instructions. The MAR is a convenient way to ensure that the "six rights" are followed: the right dose of the right medication was taken by the right patient at the right time by the right route and the right documentation was made by licensed health care staff.
After the form is fully completed, it becomes a part of a patient's permanent record.
Not what you were looking for? Check out these related topics:
Pressing the PRINT button will only print the current page. Download the document to your desktop, tablet or smartphone to be able to print it out in full.