PRESCRIBING PHYSICIAN PRESCRIPTION NO. OF NUMBER REFILLS NAME OF PHARMACY LIC 622 (3/99) (CONFIDENTIAL)
INSTRUCTIONS: Centrally stored medications shall be kept in a safe and locked place that is not accessible to any person(s) except authorized individuals. Medication records for each client/resident shall be maintained for at least one year.
Forms and Publications (I-L) - California Dept. of Social Services
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 for the Chronically Ill, and Social Rehabilitation Facilities LIC 9283 (6/23) - Infection Control Plan - Adult Day Programs
INSTRUCTIONS FOR LIC 622A – MEDICATION ADMINISTRATION RECORD (MAR) Record onto the MAR immediately after each medication is self-administered by the child. This is the only way to be sure that the right medication was taken, by …
The plan and related materials shall be on file in the facility and shall be submitted to the licensing agency with the license application. Any significant changes in the plan of operation which would affect the services to residents shall be submitted to the licensing agency for approval.
Form LIC622 Download Fillable PDF or Fill Online Centrally Stored ...
Form LIC 622, Centrally Stored Medication and Destruction Record , is a document developed by the California Department of Social Services (CDSS) . The purpose of the document is to keep a record of centrally stored medication and to keep a record of the destruction of medication.
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The LIC 622 form is provided as a courtesy to help licensees document the destruction of medication. To access the updated Centrally Stored Medication and Destruction Record form, please visit the California Department of Social Services Forms and Publications webpage.
LIC 622 - Centrally Stored Medication And Destruction Record
Form LIC 622 is used to document centrally stored medication and its destruction in licensed facilities in California.
MEDICATIONS GUIDE Residential Care Facilities for the Elderly
The Centrally Stored Medication and Destruction Record (LIC 622) is available for this purpose and identifies what information must be recorded for all centrally stored medications. o If the facility chooses to utilize a form other than the LIC 622, ensure all required information is …
Form LIC 622. Centrally Stored Medication And Destruction Record
The LIC 622 form, also known as the Centrally Stored Medication and Destruction Record, is a document used to record the inventory and destruction of centrally stored medications. The primary purpose of the form is to ensure that medications are safely stored and disposed of in compliance with applicable laws and regulations.