Criminal convictions from another State or Federal court are considered the same as criminal convictions in California. If you answer YES, give details on the back of this page indicating the nature and circumstances of each crime and the date and the location in which each crime occurred. 1. It happened a long time ago; 2.
In order to be licensed, work at, or be present at, a licensed facility, the law requires that you complete a criminal background check.
On-line Forms and Publications I - L - California Dept. of Social …
LIC 508 O-O-S (9/23) - Out-Of-State Disclosure; LIC 508D (10/23) - Out-Of-State Disclosure And Criminal Record Statement ; ... LIC 9282 (6/23) – Residential Infection Control Plan - Adult Residential Facilities, Enhanced Behavioral Supports Homes, Community Crisis Homes, Residential Care Facilities for the Elderly, Residential Care Facilities ...
LIC 508 (7/21) Page 1 of 5. State law requires that persons associated with licensed care facilities, Home Care Aide Registry or TrustLine Registry applicants be fingerprinted and disclose any conviction. A conviction is any plea of guilty or nolo contendere (no …
LIC 508 (10/95) Instructions to Licensees: If the person discloses a history with a criminal conviction, the licensee shall review the person’s attached statement and discuss it with the licensing evaluator. Such a review is in addition to the
Lic 508 Form – Fill Out and Use This PDF - FormsPal
The LIC 508 form, issued by the State of California Health and Human Services Agency, California Department of Social Services, is a mandatory document for individuals associated with licensed care facilities, those applying to the Home Care Aide Registry, or TrustLine Registry, requiring them to undergo fingerprinting and disclose any ...
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In order to be licensed, work at, or be present at, a licensed facility, the law requires that you complete a criminal background check. (Health and Safety Code sections 1522, 1568.09, 1569.17 and 1596.871.)
In order to be approved, licensed, work at, or be present at, a licensed facility, a certified family home, or home of a resource family, the law requires that you complete a criminal background check.
Form LIC508 Criminal Record Statement & Out-of-State Disclosure ...
2021年7月1日 · Download a fillable version of Form LIC508 by clicking the link below or browse more documents and templates provided by the California Department of Social Services. Download Fillable Form Lic508 In Pdf - The Latest Version Applicable For 2025.
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LIC 508D (10/23) Required Form - No Change Permitted Page 1 of 5 I. INSTRUCTIONS State law requires that a person associated to a licensed foster family home, certified family home or a
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