LIC 508 (LIC 508D): Criminal Record Statement

State law (Health & Safety Code §1569.17) requires that persons associated with licensed facilities be fingerprinted and disclose any convictions. The LIC 508 or LIC 508D, completed during the application and hiring process, asks for any criminal history of Licensees and facility employees.

Criminal Record Clearance requirement for all RCFEs.

To view the actual document, visit the link below:

http://www.dss.cahwnet.gov/cdssweb/entres/forms/English/LIC508.PDF

http://www.dss.cahwnet.gov/cdssweb/entres/forms/English/LIC508D.PDF