RCFE Forms: The California LIC Forms a Board and Care Home Actually Uses

At 2:10 on a Saturday morning a resident gets up to use the bathroom and falls. The caregiver on shift hears it, checks on her, calls 911 and runs on adrenaline for the next hour.

By Monday the fall has a deadline attached.

Licensing has to hear about it by the next working day. A written report is due within seven days. A copy goes in her file. The form is the LIC 624, and it is easy to find.

The rest of the list is harder. California publishes more than 200 LIC forms, and most of them belong to child care, foster care and other kinds of facilities. A board and care home uses about two dozen. This page names those, says which version is current and where each deadline comes from. Every form number and rule below was checked against the California Department of Social Services site.

What are RCFE forms?

RCFE forms are the LIC-numbered forms that the Community Care Licensing Division of the California Department of Social Services publishes for Residential Care Facilities for the Elderly. A six bed board and care home holds the same RCFE license as a hundred unit community, so it uses the same forms. They are free to download from the CDSS forms list.

Most of them sit on the CDSS alphabetic forms list under I-L, because every number starts with LIC. The elder abuse report is the exception. It is the SOC 341, and it lives under Q-T.

Two things that trip up a small home

The record is required. The form often is not. The regulations require the information. The LIC form is the state's version of where to put it. Title 22 says a licensee "shall be permitted to use" the LIC 603 for the pre-admission appraisal. The current LIC 602A calls itself "a courtesy." That is why a home may write its own admission agreement. What a home cannot do is skip what the form was built to collect.

The search results will hand you the wrong form. Search "RCFE forms" and a good share of the first two pages is child care paperwork from Ohio, Minnesota and Florida. Even California's own list puts near-twins side by side:

• The LIC 624B is the incident report for a family child care home. An RCFE uses the LIC 624.
• The LIC 602 is the Physician's Report for Community Care Facilities, and Title 22 still names it by number. The form CDSS publishes for RCFEs is the LIC 602A, and that is the one to download.
• The LIC 613C covers publicly operated RCFEs. A privately owned home uses the LIC 613C-2.
• The LIC 610 is a disaster plan for child care centers. An RCFE uses the LIC 610E.

Download the current version from CDSS when you need one, instead of photocopying the copy in the drawer. The LIC 602A was revised in April 2026, and a form from 2019 can still look official.

The admission packet

Most of the forms a small home touches arrive in one stack, the week a new resident moves in. Here is that stack, roughly in the order it fills up.

One more record runs alongside the packet. The register of residents, which the state prints as the LIC 9020A, lists each resident's ambulatory status, physician and responsible person. Title 22, section 87508, says licensing can inspect and copy it on demand during normal business hours.

The LIC 602A, still called the physician's report

The LIC 602A is the medical assessment a California RCFE gets before it accepts a new resident. Its current title is Medical Assessment for Residential Care Facilities for the Elderly, and the current version on the CDSS site is dated April 2026.

Most people in the business still call it the physician's report, and they have a reason. Title 22, section 87458, still says a licensee may use "the form LIC 602 (Rev. 9/89), Physician's Report." The LIC 603 says it is "not a substitute for the Physician's Report (LIC 602)." The current LIC 602A asks for a licensed medical professional instead.

What it covers is the question every admission turns on: can this home safely care for this person? The form asks for diagnoses, medications and whether the resident can manage them. It asks about cognitive conditions, tuberculosis results, other contagious or infectious diseases and allergies. Then it asks whether the resident is ambulatory, nonambulatory or bedridden. Last, it asks whether hospice is involved. It opens with a reminder printed in capital letters that these facilities cannot provide skilled nursing care.

How long is a LIC 602A good for?

Title 22, section 87458, asks for a medical assessment made within the last year, on file before the person is accepted as a resident. Under Title 22, section 87705, a resident with dementia needs a new medical assessment every year.

Licensing can also require an updated assessment. The care plan runs on its own clock. Title 22, section 87463, calls for a reappraisal whenever a resident's condition changes in a significant way, such as a stroke, a heart attack or the loss of someone close. The same section also calls for a meeting with the resident, her representative and facility staff after any significant change or every 12 months, whichever comes first.

The admission agreement

The LIC 604A is a guide to admission agreements with a model agreement built in. CDSS says you may use it as a guide to write your own, or modify and use the form itself.

Whether a home writes its own agreement or adapts the LIC 604A, Title 22, section 87507, lists what the agreement has to cover. Here is part of that list. Basic services. Optional services and what they cost. Who pays, how much and when. Refund conditions. The conditions that can lead to an eviction. The home's policy on family visits. That licensing may examine resident records.

Rate increases are where an old agreement is most likely to be out of date, because the state's own documents disagree. Title 22, section 87507, still says at least 30 days of written notice for a basic rate change. The LIC 604A, which cites the Health and Safety Code, calls for no less than 60 days of written notice before a general rate increase, with the amount, the reason and a general description of the added costs. When a resident moves to a higher level of care that raises the rate, written notice is due within two business days of starting the new service.

The resident and the responsible person each get a copy of the agreement. The original stays in the resident's file.

Incident reports and death reports

These are the two forms an owner most wants to get right, because they arrive on the worst days.

The LIC 624 incident report

The LIC 624 tells you to notify the licensing agency, the placement agency and the resident's responsible person by the next working day. The written report is due within seven days. A copy stays in the resident's file.

The form's checklist shows how wide "incident" runs. Injuries from an accident or of unknown origin. A hospitalization. A medical emergency. An unauthorized absence. Alleged abuse, theft, a fire, an epidemic outbreak. Title 22, section 87211, adds the use of an automated external defibrillator and any serious injury the attending physician confirms happened while the resident was in your care.

A few events run on shorter clocks. Section 87211 calls for an epidemic outbreak, a poisoning or a major accident to be reported to licensing within 24 hours by phone or fax, and to the local health officer when appropriate. A fire or explosion is reported to the local fire authority immediately and to licensing no later than the next working day.

The LIC 624A death report

The LIC 624A says the licensee must report the death of a resident from any cause, regardless of where the death occurred. Title 22, section 87211, spells out that this includes a day program, a hospital, the trip to or from a hospital and a visit away from the home. The same clock applies: notice by the next working day, the written report within seven days. If a coroner's report is made, a copy goes to licensing within 30 days.

The SOC 341 elder abuse report

Suspected abuse goes on a different form with different clocks. The SOC 341 is the state's Report of Suspected Dependent Adult/Elder Abuse, and its own instructions set the deadlines by what happened and where. Some are measured in hours. Read that page of the form now, on a quiet afternoon, so nobody is reading it for the first time at 2am. Its companion, the SOC 341A, is the statement acknowledging the duty to report suspected abuse of elders and dependent adults.

The forms that live in the binder

A handful of records sit in the office and come out at inspection.

The LIC 610E is the emergency and disaster plan. The form says the plan must be in writing and available on request to residents, responsible parties, the local long-term care ombudsman and local emergency responders. Staff are trained on it at hire and every year after. Drills run at least quarterly for each shift.

The medication records are the LIC 622, for centrally stored medication and its destruction, and the LIC 622A, the medication administration record.

The staff file holds the LIC 500 personnel report, the LIC 501 personnel record and the LIC 503 health screening report.

The personal rights from the LIC 613C-2 also go on the wall. Personal rights, the nondiscrimination notice and complaint information are posted in a prominent spot that residents, families and the public can see. They go up in English and in any language that at least 5% of residents can read only in that language.

The record no form asks for

Every admission packet above starts the same way, with a phone call. A daughter at a hospital discharge desk, a case manager with a patient ready to leave, a son who just watched his mother struggle with the stairs.

The state has a form for nearly everything that happens after that call. It has none for the call itself. A home that misses it usually never finds out, because a call nobody answered leaves no trace.

In a small home the person who would answer is often the caregiver on shift, in the middle of helping a resident. Nobody is slacking. One person cannot help a resident and answer the phone at the same time. That is physics. The cost of the gap has a name, the Voicemail Tax, and it comes out of every referral and every marketing dollar that made the phone ring.

For the marketing side of filling beds in a small home, see assisted living marketing for a six to sixteen bed home, and for larger communities, senior living marketing.

What to do this week

Pull the current LIC 602A, LIC 624, LIC 624A and LIC 613C-2 from the CDSS forms list and swap them for the copies in your binder. Read the time frames page of the SOC 341 with whoever covers your overnight shift. Then check your own phone line the way a family would, and grade your line and five competitors after hours.

To hear what an AI Admissions Agent for Senior Living sounds like on that call, phone Sloane at (949) 779-6255 and try to break her. Be the case manager with a patient who needs a bed by Friday.