The Lic 9188 form, issued by the State of California Health and Human Services Agency and the California Department of Social Services Community Care Licensing Division, serves a critical function in the transfer of active criminal record exemptions between state-licensed facilities. This process enables a licensee or license applicant to request the transfer of an individual’s criminal record exemption to another facility, ensuring that regulatory compliance is maintained to prevent violations and potential civil penalties. It's essential that the department's approval is obtained before the individual starts having contact with clients in the new facility. The requestor must verify the identity of the individual using valid photo identification and, if transferring to a facility that serves children and a Child Abuse Central Index (CACI) check has not previously been done or is outdated, submit a new CACI check directly to the Department of Justice. Notably, this form emphasizes the importance of maintaining legal and regulatory standards within California’s network of care facilities, focusing on safeguarding the well-being of clients and upholding the integrity of care providers. Furthermore, the inclusion of a privacy statement in the form highlights the balance between transparency, privacy, and security, underlining the measures taken to protect individuals' information while complying with state laws and societal expectations.
| Question | Answer |
|---|---|
| Form Name | Form Lic 9188 |
| Form Length | 2 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 30 sec |
| Other names | lic 9188 form, criminal record exemption letter, ca lic 9188, criminal record exemption transfer request form |