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Get Ca Lic 622 1999-2026
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How to fill out the CA LIC 622 online
The CA LIC 622 form is essential for documenting centrally stored medication and its destruction records within health and human services facilities. This guide provides clear, step-by-step instructions for users to accurately complete the form online.
Follow the steps to successfully complete the CA LIC 622 online.
- Press the 'Get Form' button to access the CA LIC 622 form and open it for editing.
- Begin by entering the facility's name in the designated field at the top of the form. Ensure it is spelled correctly to maintain accurate records.
- Next, input the facility number. This information is crucial for identifying the specific facility within licensing databases.
- In the following section, enter the resident's name. Fill in the last name, first name, and middle name as required.
- Proceed to document the medication name, along with its strength and quantity. Accuracy in this section is important to ensure proper medication management.
- Fill in the expiration date of the medication, the admission date of the resident, the date the medication was filled, and the date the medication was started.
- Record the names of the attending physician and the prescribing physician, along with the prescription number and the number of refills if applicable.
- Document the name of the pharmacy that provided the medication.
- If applicable, repeat the previous steps for any additional medications that need to be recorded.
- For medication destruction records, document the medication name, strength, quantity, date filled, and prescription disposal number in the appropriate section.
- Include the date of destruction, along with the signatures of the administrator or designated representative and a witness who is not a client or resident.
- Once all fields are accurately filled, review the entire form for completeness and accuracy. Users can then save changes, download, print, or share the completed form as needed.
Complete your CA LIC 622 form online today for efficient document management.
LIC 500 is a form that helps collect important background information about individuals working in a licensed facility in California. This form is instrumental in ensuring that all staff meet the necessary qualifications and standards. By addressing the requirements associated with LIC 500, facilities can better align with CA LIC 622 guidelines for safety and care.
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