Please rate Form Lic 610D 12-21
The plan shall be reviewed annually, updated as necessary, and maintained on file at the facility.
Who signs: a licensee or administrator shall sign and date the plan to show that it has been reviewed and updated as necessary.
Staff training: a licensee of all residential facilities except ARFPSHNs must provide training on the plan to all staff upon hire and annually thereafter.
Adult day programs: all licensees of ADPs and ARFPSHNs must conduct drills at least every 6 months.
Temporary shelters: a licensee must list at least two appropriate shelter locations; one of the locations must be outside the immediate area.
Confidential: all resident/client and employee information on this form must be kept confidential.
| Question | Answer |
|---|---|
| Form Name | LIC 610D |
| Form Length | 9 pages |
| Fillable? | Yes |
| Fillable fields | 170 |
| Avg. time to fill out | 29 min |
| Edition | 12/21 |
| Issuing agency | California Department of Social Services |
| Plan review | Annually |
| Matches the agency's file | Yes, checked October 2, 2026 |
| Other names | LIC 610D, LIC610D, LIC-610D, Form LIC 610D, LIC 610D Form, Emergency and Disaster Plan, California Emergency and Disaster Plan |
| Official source | LIC 610D (Rev 12/21), California Department of Social Services |
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Please rate Form Lic 610D 12-21
