LIC 809: Facility Evaluation Report

Understanding CCLD Forms

The LIC 809 or Facility Evaluation Report is the key record of the state's inspection of an RCFE.  The Licensing Program Analyst (LPA) uses this document during site visits to record the compliance of a facility.  

This document can be viewed in conjunction with Compliant Investigation Reports (LIC 9099s) to better inform the consumer about a facility's performance.  Consumers can view these public documents on CARR's website by using the Facility Search, or by filing a request with Community Care Licensing Division (CCLD).

To view the form:

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