The LIC 9163 Facility Number form is a crucial document used within the State of California, managed by the Health and Human Services Agency and the California Department of Social Services. Its primary purpose is to facilitate the process for individuals seeking to work, volunteer, or reside in community care licensing facilities to undergo background checks through the Live Scan fingerprinting system. The form is meticulously structured to gather comprehensive applicant information, including personal details and the specific type of community care facility related to the applicant's submission. Categories covered range from home care aides to residential care facilities for the elderly, indicating the broad scope of community care licensing. Additionally, the document facilitates communication between the California Department of Social Services and the Department of Justice by providing pre-printed sections for agency addresses and specific codes for processing. Notably, the form includes sections for entering applicants' identifying information, the facility number, and details concerning the Live Scan transaction, emphasizing the importance of accuracy and transparency in the background check process. Privacy considerations are also addressed, informing applicants about how their social security numbers and other personal data will be used and protected. This comprehensive approach not only streamlines the background check process for community care licensing but also underscores California's commitment to the safety and well-being of individuals in these care environments.
| Question | Answer |
|---|---|
| Form Name | Form Lic 9163 Facility Number |
| Form Length | 4 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 1 min |
| Other names | community care licensing form, request for live scan service lic 9163, california lic community care, lic 9163 live scan form |
