Form LIC 308 at a glance
What it is: Designation of Facility Responsibility is the form licensees use to delegate authority to appropriate staff.
Who signs: SIGN on the Signature of applicants/licensees line.
Licensed facilities are required to have an authorized person continuously present at the facility during operational hours to represent the facility and to accept licensing reports.
What to bring and attach to Form LIC 308
Applicants/licensees who are corporations shall attach board resolutions authorizing this delegation.
A filled-in Form LIC 308 example: a licensee names one staff member
How to fill out Form LIC 308, box by box
Facility Name, Date, Facility Number, Facility Address, Phone, City and County
Enter the Facility Name and the Date.
Enter the Facility Number.
Enter the Facility Address and the Phone.
Enter the City and the County.
In the event of my absence I designate
After "In the event of my absence I designate", write the NAME. He/She is authorized to receive any documents including reports of inspections and consultations, accusations and civil and administrative processes on your behalf at the facility.
Title, Address, City County Zip
Enter your Title.
Enter your Address.
Enter the City, County and Zip.
More rules for Form LIC 308
When delegating authority to appropriate staff, Residential Care Facilities for the Elderly shall comply with CCR Title 22, Division 6 Section 87564, Child Care Centers shall comply with CCR Title 22, Division 12 Section 101215.1 and other licensed facilities shall comply with CCR Title 22, Division 6 Section 80064.
Common questions about Form LIC 308
Is there a deadline?
Notify the licensing agency, in writing, within 10 days of any change in the authorization.
Sources
[1] Form LIC 308 (11/02), Designation of Facility Responsibility, California Department of Social Services Community Care Licensing (the Official source link on this page).