Get Ca Lic 200 2011-2026

The CA LIC 200 form is essential for applying for a license to operate a community care facility or residential care facility for the elderly in California. This guide provides clear, step-by-step instructions to help you fill out this form online effectively.

Follow the steps to successfully complete the CA LIC 200 online.

1. Click 'Get Form' button to access the document and open it in your preferred editing tool.
2. Enter the full names of the applicant(s) in the designated 'Applicant(s) Name(s)' field. Be sure to include first, middle, and last names.
3. Provide the applicant's legal home mailing address in the 'Applicant Mailing Address' section, ensuring to include the area code and telephone number.
4. Select the type of agency or facility by checking the appropriate box in the relevant field. If the type is not listed, you may specify in the 'Other' section.
5. Indicate the requested action by checking one of the options such as initial application or change of capacity.
6. Complete the 'Facility or Agency Name' section with the name used to designate the facility you are applying for.
7. Fill in the physical address of the facility under 'Facility Street Address' and ensure you provide the area code and telephone number.
8. If the facility has a different mailing address, complete the 'Facility Mailing Address' section.
9. Enter the name and title of the administrator or person in charge of the facility.
10. Fill out the 'Total Requested Capacity' field with the total number of persons you plan to provide care for in a 24-hour period.
11. If applicable, specify the number of beds for non-ambulatory or bedridden individuals in the sections provided.
12. If you are applying for a children's facility, complete the sections regarding the number of infants and children.
13. Indicate the days and hours of operation for the facility.
14. Check the appropriate box regarding property ownership to indicate if you own, rent, or lease the facility.
15. State whether major construction is required and provide dates for commencement and completion if applicable.
16. Specify the source of water for human consumption by checking either 'Public' or 'Private.'
17. List any other facilities previously or currently operated and refer to the instructions for any additional information required.
18. Acknowledge your responsibilities as stated in the form regarding compliance with applicable laws and regulations.
19. Confirm that you understand your right to appeal any decisions regarding your application.
20. Sign the form, ensuring all applicants or authorized persons include their titles, counties, and dates signed.
21. Once all fields are completed, save changes, then choose to download or print the completed form for your records.

Complete your application for the CA LIC 200 online today and take the first step towards operating your facility.