Physician's Report For Community Care Facilities (LIC 602)

This government document is issued by Department of Social Services for use in California

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http://www.cdss.ca.gov/cdssweb/entres/forms/English/LIC602.PDF
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  • Forms And Publications I - L

The purpose of the LIC 602 form is to collect information about an individual seeking admission or continued care in a residential care facility. The California Department of Social Services uses the form to determine whether the individual is appropriate for such care.

The form requests information about the individual's personal and medical history, as well as their functional abilities and needs. This information is used to evaluate the individual's suitability for admission to or continued care in a residential care facility.

To fill out the form, the individual or their authorized representative must provide accurate and complete information about their history, needs, and abilities. The form should be submitted to the facility or agency responsible for the individual's care.

The LIC 602 form is just one part of the evaluation process for admission to or continued care in a residential care facility in California. The facility or agency may require additional documentation or assessments before deciding on suitability for care.

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