LIC 503: Health Screening Report Facility Personnel

CARR Initiates Petition To Require Mandatory Liability Insurance for RCFEs

The LIC 503 is required as part of the application process, and is used to verify the health (general well-being, lack of communicable diseases, etc.) of the Licensee and/or administrator, if they are different people.  It is also used within facilities during the hiring process for staff. It requires completion and signature by a physician

To view: http://www.dss.cahwnet.gov/cdssweb/entres/forms/English/LIC503.pdf