Lic 624 Death Report. Download it as a PDF or fill it out digitally and save as a p

Download it as a PDF or fill it out digitally and save as a printable PDF. LIC 624 Unusual Incident/Injury Report L. LIC 622 Centrally Stored Medication and Destruction Record N. SUBMIT WRITTEN REPORT WITHIN 7 DAYS OF OCCURRENCE. INSTRUCTIONS : NOTIFY LICENSING AGENCY, PLACEMENT AGENCY AND RESPONSIBLE PERSONS, IF ANY, BY NEXT WORKING DAY. It was reported that Resident #1 (R1) was able to elope from the community unsupervised. HOW AND WHEN TO REPORT: Affected facilities may (but are not required to) use the LIC 624-LE to report incidents under the law. TODAY’S DATE FACILITY LICENSE NUMBER: usual incident/injury”. The Incident Report LIC 624 form is a crucial document used by the California Department of Social Services Community Care Licensing Division. You must also complete the Unusual Incident Report (UIR) LIC 624 for centers or LIC 624b for family child care homes within one business day.

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