Form LIC 405, Record of Client's/Resident's Safeguarded Cash Resources, is a legal document needed to safeguard and maintain accounting records regarding the resident cash resources. Residents of the community care facilities may be incapable of handling their own resources, and the representatives of these facilities provide them with assistance. Form LIC 405 allows the facility to maintain an accurate and current account of resident cash resources with supporting receipts.
This form was released by the California Department of Social Services (CDSS), a component of the California Health and Human Services Agency (CHHS). The latest version of the form was issued on August 1, 2001, with all previous editions obsolete. You can download a fillable LIC 405 Form through the link below.
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