Navigating the procedural aspects of transferring active criminal record clearances between state-licensed facilities or organizations is efficiently handled through the LIC 9182 form, which serves as an essential document in the State of California, under the oversight of the Health and Human Services Agency and the California Department of Social Services’ Community Care Licensing Division. This form is a critical tool for license applicants or licensees who wish to transfer criminal background clearances of individuals, ensuring the smooth continuation of their employment or association with a different licensed entity without compromising on client safety or legal compliance. It mandates the submission of specific identification documents and, where applicable, a Child Abuse Central Index (CACI) check to validate the transfer request. Additionally, this process highlights a commitment to privacy and adherence to federal and state regulations concerning personal information while making clear the repercussions of unapproved or delayed transfers, particularly the risks of violating laws and the imposition of civil penalties. With detailed instructions on its usage, the LIC 9182 form underscores a procedural necessity for facilitating workforce mobility within California’s network of health and human services while upholding stringent safety and regulatory standards.
| Question | Answer |
|---|---|
| Form Name | Form Lic 9182 |
| Form Length | 2 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 30 sec |
| Other names | illinois state police blank dom of information release form, lic9182, criminal background transfer request, seq |