Form LIC9186 Client Death Report - California

Form LIC9186 Client Death Report - California

What Is Form LIC9186?

This is a legal form that was released by the California Department of Social Services - a government authority operating within California. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is a LIC9186 Client Death Report?
A: LIC9186 Client Death Report is a form used in California to report the death of a client to the Department of Social Services.

Q: Who needs to fill out the LIC9186 Client Death Report?
A: The form should be completed by the facility or individual responsible for the care of the deceased client, such as a residential care facility or a home care agency.

Q: What information is required on the LIC9186 Client Death Report?
A: The form requires information about the deceased client, including their name, date of birth, date of death, and the cause of death. It also asks for information about the facility or agency and the person completing the form.

Q: When should the LIC9186 Client Death Report be submitted?
A: The form should be submitted within 7 days of the client's death.

Q: Why is the LIC9186 Client Death Report important?
A: The report helps the Department of Social Services track and monitor deaths of clients in care facilities to ensure the safety and well-being of vulnerable individuals.

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Form Details:

  • Released on February 1, 2001;
  • The latest edition provided by the California Department of Social Services;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;

Download a fillable version of Form LIC9186 by clicking the link below or browse more documents and templates provided by the California Department of Social Services.

Download Form LIC9186 Client Death Report - California

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