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Compliance calendar
Upcoming renewals, annual reviews, and CDSS deadlines - all in one view.
Document library
Every document you've purchased, all in one place.
Free compliance posters
All 8 required notices sourced directly from official California and federal agencies. Download and print for your facility at no cost.
RCFE-required compliance posters (CDSS)
SB 895
"See Something, Say Something" Poster
Required at main entryway. Print at 20"×26" - exact size is mandated. Violations are subject to daily fines. Source: CDSS PUB 475.
⬇ Download PDF
AB 1572
Rights of Resident Councils Poster
Required at every RCFE under H&S Code §1569.157. Failure to post carries a $250/day civil penalty until corrected. Source: CDSS PUB 474.
⬇ Download PDF
California labor law posters (CA DIR)
Minimum Wage Order 2026
Current California minimum wage notice required to be posted in all workplaces. Updated annually. Source: CA DIR / IWC.
⬇ Download PDF
Paid Sick Leave Notice
Required posting explaining employee paid sick leave rights under California law. Source: CA Labor Commissioner.
⬇ Download PDF
Whistleblower Protections Notice
Must be posted prominently in lettering larger than 14pt. Lists employee rights under California whistleblower laws. Source: CA DIR.
⬇ Download PDF
Know Your Rights 2026
New annual requirement effective February 1, 2026. Must be distributed to all employees each year. Source: CA Labor Commissioner.
⬇ Download PDF
Additional required CA posters: Pay Day Notice, IWC Wage Order (Order 5 applies to most care facilities), Workers' Compensation Insurance notice (obtained from your WC carrier). All available free at dir.ca.gov/wpnodb.html.
Federal labor law posters (US DOL)
Equal Employment Opportunity (EEO)
Required to be posted in all workplaces with 15+ employees. "Know Your Rights" poster covering federal anti-discrimination laws. Source: EEOC.
⬇ Download PDF
All Federal Posters (Full List)
FLSA minimum wage, FMLA, OSHA Job Safety & Health, and other federal notices. All free to download directly from the US Department of Labor.
→ Go to DOL posters page
California anti-discrimination notice (CRD)
Harassment or Discrimination Prohibited (DFEH-162)
Required under FEHA / Government Code §12900. Available in multiple languages. Source: California Civil Rights Department (formerly DFEH).
→ Get from CRD website
Printing note: The SB 895 poster (PUB 475) must be printed at exactly 20"×26". Other posters do not specify a size but must be legible and prominently displayed. A local print shop can print the larger sizes inexpensively from the PDFs above.
Account settings
Manage your contact info and notification preferences.
Contact information
✓ Changes saved.
Welcome back, Maria
Here's where things stand on your full license package.
About this checklist: the percentages, checkmarks, and "of N documents complete" counts above are computed live from your actual order. The explanatory text inside each document when you expand it (what it is, why CDSS requires it) is reference material, not a live per-field tracker. For the full document-by-document status, see your Document Library.
Your license package
68%
✓
Preliminary package
Completed Jun 12, 2026 · - of 5 documents complete
100%
✓
Section A - applicant & facility
Verified against current DSS form
100%
•
Section B - policies & staffing
In progress · - of 13 documents complete
55%
•
Supplemental package
In progress · 0 of 2 documents complete
55%
3
S1 - LIC 9282 Residential Infection Control Plan
Drafted for you, with your full Infection Control Plan attached
70%
This is the cover form CDSS requires for your Infection Control Plan. Your facility name, administrator, and contact details are filled in automatically. If you'd rather not review this yourself, your admin will complete it.
Sunrise Residential Care - Applied ForFacility & license number
Maria TorresAdministrator
412 Harbor Way, Sacramento, CA 95814Facility address
(916) 555-0142From A1
A. Infection control requirements
Your full Infection Control Plan, attached separately, addresses both required sections in detail - standard precautions, hand hygiene, PPE, cleaning and disinfection, respiratory etiquette, injections, sharps handling, and procedures for a resident with a communicable disease.
B. Infection control training plan
Maria TorresFrom Administrator (A1), unless a different staff member is designated
(916) 555-0142From A1
Training requirements, initial orientation, and ongoing training plans are addressed in full in the attached Infection Control Plan.
Provided as a courtesy to help you keep a log of reviews and updates
+ Add review entry
C. Emergency infection control plan
Requirements for an Emergency Infection Control Plan - activated if a local, state, or federal emergency for a communicable disease is proclaimed - are addressed in the attached Infection Control Plan's final section.
Provided as a courtesy to help you keep a log of reviews and updates
+ Add review entry
Attachment
Infection Control Plan
Generated for your facility · attaches behind this form · last reviewed Jun 16, 2026
4
S2 - LIC 606 RCFE Disclosure Worksheet
Several disclosure questions need your direct answer
40%
This worksheet helps CDSS evaluate the reputable and responsible character of everyone connected to your facility, per AB 601. We've filled in everything we already know - several questions below are genuine legal disclosures with no safe default, so they're left unanswered until you choose. If you'd rather not complete this yourself, your admin will finish it.
Sunrise Residential Care - Applied ForFacility & license number
Maria Torres, James TorresApplicant/co-applicant
Part 1 - General information
Addendum to an applicationAuto-filled
For-profit providerFrom your business structure (Step 2)
info@sunrisecare.comFacility email of record
Part 2 - Evidence of reputable and responsible character
Yes - your A1 ownership list already serves as this disclosure10%+ beneficial owners list
Is a separate list attached disclosing individuals/entities with operational control of the facility?Must answer
YesNo
⚠ Not yet answered
YesCriminal record statements (A13/LIC508)
YesEmployment history (A2/LIC215)
Were fingerprints and Form 9163 submitted for everyone identified above?Must answer
YesNo
⚠ Not yet answered
Part 3 - Other facilities
Do you have other health, residential, or community care facilities owned, managed, or operated by you, anywhere in the U.S.?Must answer
YesNo
⚠ Not yet answered
A list of these facilities is required as part of S2's attachment. Upload the lease agreement(s) for those additional facilities in the "Lease agreements" section below, right after the attachment.
Do any parent organizations of your business have other such facilities?Must answer
YesNo
⚠ Not yet answered
Part 4 - Real property owners & right to possession
Yes - from your property owner info (A1)Property owner list, this facility
Yes - from your B11 uploadRight to possession evidence
Part 5 - Individuals/entities with operational control
Is a separate list attached with prior/present service history for individuals with operational control?Must answer
YesNo
⚠ Not yet answered
Part 6 - Administrative disciplinary actions
Do you or anyone with operational control of your facility have any administrative disciplinary actions (revocation, suspension, probation, exclusion order) within the past 10 years?Must answer
YesNo
⚠ Not yet answered
Provide details - name, filing agency, court, case number, date filed, current status - in S2's attachment, along with copies of related documents (accusations, findings, orders, stipulations).
Part 7 - Bankruptcy filings
Do you have any bankruptcy filings involving the operation or closure of a health, residential, or community care facility within the relevant time period?Must answer
YesNo
⚠ Not yet answered
Provide details - name, court, case number, date filed, current status - in S2's attachment, along with copies of related documents.
Part 8 - Chains of licensees
A facility is part of a "chain" when two or more licensees are controlled or directed by the same individuals or entities.
Is this facility's applicant or licensee part of a chain?Must answer
YesNo
⚠ Not yet answered
A relationship diagram with ownership percentages, plus a supporting sheet for each individual/entity, is required in S2's attachment.
Part 9 - Management companies
Does your facility include a management company serving as co-licensee?Must answer
YesNo
⚠ Not yet answered
Is the management company part of a chain?
YesNo
Attachment
LIC 606 Additional Worksheet
Attaches behind this form · itemized detail for every "Yes" answer above
If you own or lease more than one RCFE facility, attach the lease agreement for each one here. This stays optional if this is your only facility.
Upload lease agreement(s) for any additional facilities you own or lease
PDF, JPEG, or PNG · one per facility if you have more than one
4
Final review & release
Reviewed by a licensing specialist
Documents ready so far
Preliminary package
Completed Jun 12, 2026 · PDF
Section A
Completed Jun 14, 2026 · PDF
Section A - applicant & facility
40%
•
A1 - LIC 200 Application
Needs your input on a few fields below
40%
Sunrise Care Holdings LLCFrom your business info
Select one
A. Initial Application
B. Change of Capacity
C. Change of Location
D. Change of Facility Type
E. Change of Facility Name
F. Change of Ownership
G. Add/Change Management Company
H. Change Within Corporation
I. Change of AMB/NON AMB Bedridden Status
J. Other
412 Harbor Way, Suite 200, Sacramento, CA 95814 · (916) 555-0142From your business info
We only handle Residential Care Facilities for the Elderly, so this is locked in for every application
Residential Facilities - Elderly
Adoption Agencies
Adult Day Programs
Adult Residential Facilities
Group Homes
Other facility types
Select one
A. Individual
B. Partnership
C. Non-Profit Corp.
D. Profit Corp.
E. County
F. Other Public Agency
G. Limited Liability Company
Sunrise Residential CareFrom intake
info@sunrisecare.comFrom intake
(916) 555-0142Primary
(916) 640-9105Alternate
Maria TorresFrom intake
AdministratorAuto-filled
Total requested
6From intake
Non-ambulatory
2From intake
Bedridden
1From intake
Not applicable - RCFE serves elderly residents only, so this section is left blank on every application
Daily, 24 hours, 365 days per yearAuto-filled
We've pre-selected this based on your intake answers - change it if needed
Own
Rent/Lease
Other
Required if renting or leasing
Yes
No
If yes, facility name and number, plus licensing agency (auto-filled as "CDSS")
Yes
No
Construction start date
Completion date
Public
Private
List any other residential care or health care facility you've operated
Remove
+ Add another facility
Beyond the first two rows, additional entries are compiled into a separate Word attachment that's included with your application - you don't need to do anything extra.
Add every owner or shareholder and their percentage of ownership. Percentages must add up to 100%.
By signing below, I/we acknowledge and agree to the following, exactly as stated on the official LIC 200 form:
A. In addition to complying with the Health and Safety Codes and regulations applicable to licensing and fire safety, I/we understand that there may be other state, federal and/or local laws, which are not enforced by this agency, that may need to be met such as: zoning, building, sanitation and labor requirements.
B. I/We have read and understand the statutes and regulations which pertain to my/our licensing category prior to the issuance of my/our license.
C. I/We shall ensure that all persons subject to fingerprint requirements shall have a Department of Justice clearance or a criminal record exemption prior to employment, residence or initial presence in the facility as required.
D. If I/We operate a facility which provides care and supervision to children, I/We shall ensure that a Child Abuse Index Check Form for each person subject to fingerprint requirements is submitted to the Department of Justice as required. (Not applicable to RCFE.)
E. I/We shall obtain approval from the licensing agency prior to making any change(s) that affect the terms of the license.
Every applicant/owner listed above signs separately. We'll add a signature block automatically for each owner you added.
The LIC 200 form itself accepts an electronic signature as legally binding. That said, you mentioned wet signatures will be required as part of the licensing package submission process - we'll follow that requirement and let each owner know exactly when and how to sign once the package is ready.
•
A2 - LIC 215 Applicant Information
One required for every owner · 0 of 2 started
0%
LIC 215 must be completed separately by every applicant/owner - not once for the whole business. We've generated one form per owner from your ownership list on A1. Each owner can fill in their own, or your admin can complete it on their behalf.
Owner 1
Form 1 of 2
•
A3 - LIC 308 Designation of Facility Responsibility
A few fields need your input below
60%
This form designates who can act on your behalf at the facility and accept licensing reports when you're not there. Most fields are filled in automatically from your facility information - you only need to tell us who that designated person is. If you'd rather not fill this in yourself, your admin can complete it for you.
Sunrise Residential CareFrom intake
Jun 16, 2026Today's date
Applied ForFrom Section A
412 Harbor Way, Sacramento, CA 95814 · (916) 555-0142From intake
Sacramento · Sacramento CountyFrom intake
Who should act on your behalf at the facility, and accept reports and notices, when you're not present? Leave this blank and we'll default to your facility administrator.
Maria TorresDefault - your administrator
Every owner listed on A1 signs this form. We'll add a signature block for each one automatically.
•
A4 - LIC 309 Administrative Organization
Tell us your business structure to continue
25%
This form must be updated and resubmitted any time your ownership, officers, or corporate structure changes. Most of it is fillable by you - if you'd rather not, your admin or our team can complete it for you using your intake answers.
Select the one that matches your business - only that section will show below
Corporation / LLC
Public Agency
Partnership
Other Association
Sunrise Residential CareFacility name
Applied ForFacility number
Jun 16, 2026Today's date
Sunrise Care Holdings LLCFrom your business info
4. Place of incorporation/registration
Corporation/LLC number
From Secretary of State filingFrom A1
Articles of Incorporation/Organization, By-Laws or Operating Agreement, and (for corporations) a Resolution authorizing this filing. We already collect your Articles and Operating Agreement as part of Section B, document B1 - you don't need to upload them again here.
YesNo
Reused automatically from your ownership list on A1 - no need to re-enter
Your administrator and entity details are pre-filled from intake - these four answers describe how your board, managers, or managing members are structured. Pick whatever's closest, or choose "Other" to specify.
Add every director, manager, or officer. For officer roles (President, Vice-President, Secretary, Treasurer), note the role in the title field.
Federal
State
County
City
Other
Attach a map if necessary - this can be uploaded once your package reaches final review.
Attach a copy of the Resolution or legal document authorizing this application. We'll prompt you for this upload during final review.
List each partner, whether general or limited, and their principal business address
Attach a copy of the partnership agreement. We'll prompt you for this upload during final review.
Other associations must also provide a list of persons legally responsible for the organization and the legal documents establishing that responsibility. We'll prompt you for these during final review.
•
A5 - LIC 400 Affidavit Regarding Client/Resident Cash Resources
Confirm whether you'll handle resident cash
50%
California requires this affidavit on every new application to confirm whether your facility needs a surety bond for handling resident cash. This is fillable by you - if you'd rather not, your admin or our team can complete it using your intake answers.
Maria Torres, James TorresFrom A1 ownership list
Sunrise Residential CareFacility name
412 Harbor Way, Sacramento, Sacramento CountyStreet, city, county
Elderly (residents) - 60 years and olderPre-selected for RCFE
Most facilities select "will not handle any" - change this if your facility will manage resident funds
Will handle cash - specify monthly maximum
Will not handle any cash resources
Use the table below as a reference - we don't calculate this for you, since it's a financial decision specific to your facility
| Amount safeguarded per month | Bond required |
|---|---|
| $750.00 or less | $1,000.00 |
| $751.00 to $1,500.00 | $2,000.00 |
| $1,501.00 to $2,500.00 | $3,000.00 |
Every additional increment of $1,000 (or fraction thereof) above $2,500 adds another $1,000 to the required bond.
Every applicant/licensee listed above signs separately
6
A6 - LIC 402 Surety Bond
Only needed if you handle resident cash
N/A
Based on your answer in A5, your facility will not handle resident cash resources - so a surety bond isn't required, and this form is marked Not Applicable automatically. If that changes later, update your answer on A5 and this form will reopen.
Because you indicated on A5 that you'll handle resident cash, a surety bond is required. Most of this form depends on your bonding company, so some fields will stay pending until they're provided.
Sunrise Care Holdings LLC · 412 Harbor Way, Sacramento, CA 95814From your business info
From your A5 answerSame bond amount as A5
Sunrise Residential CareFacility name
Applied ForLicense number - from your intake answer (Step 3)
You'll need to provide this once you've selected a bonding company
⏳ Pending bonding company - this is filled in by your surety company once your bond is issued, not by you or our team
This doesn't hold up the rest of your package. We'll track it separately and follow up once your bonding company has signed.
•
A7 - LIC 401 Monthly Operating Statement
Review your numbers - totals calculate automatically
70%
Enter your figures below - every total calculates itself as you type, and your answers save automatically as you go, so you never need to add these up by hand. If you'd rather not fill this in, your admin or our team can complete it from your intake answers.
Sunrise Residential CareFacility name
412 Harbor Way, Sacramento, CAFacility address
Applied ForApp./Lic. No.
Pending facilities (not yet operating) report Estimated. Operating facilities report Actual. This applies to every figure on this statement.
Estimated
Actual
Program revenues
1.SSI Revenue (Monthly SSI Rate × # SSI Clients)
2.Voluntary 3rd Party Contributions
3.Private Revenue (6 private-pay residents)
Other revenues related to the facility
4.Other revenue item
5.Other revenue item
6.Total Revenue
$0.00
Care and services
7.Food Costs
8.Household Supplies
9.Laundry and Dry Cleaning
10.Personal Hygiene Items
11.Recreational Activities
12.Newspapers, Magazines, Cable TV
13.Medical and First Aid
14.Client Transportation
15.Total Care & Services$0.00
General administration
16.Salaries and Wages
17.Payroll Taxes and Employee Benefits
18.General Transportation
19.Telephone
20.Office Supplies
21.Advertising
22.Fees for Licenses and Memberships
23.Contract Labor
24.Insurance (Liability and Fire)
25.Indirect Overhead
26.Total General Administration$0.00
Physical plant
27.Rent, Lease, Mortgage & HOA Fees
28.Property Taxes
29.Gas
30.Electricity
31.Water
32.Garbage
33.Repair & Maintenance (Building)
34.Repair & Maintenance (Furniture & Equipment)
35.Other (specify)
36.Total Physical Plant$0.00
37.Total Operating Costs$0.00
38.Net Profit (Loss)$0.00
•
A8 - LIC 401a Supplemental Financial Information
Covers your whole business - no need to repeat per owner
80%
Your business structure is Corporation/LLC (from A4), so this form covers your business as one shared submission - corporations are excluded from the per-partner asset disclosure on line 22, and one filing is sufficient.
This switches automatically based on your business structure from A4 - shown here so you can compare both
Corporation / LLC - one shared form
Partnership / Sole Proprietor - one form per person
This form is one submission covering your business as a whole, not a separate copy per owner. Most lines start as $0.00 or N/A since that's the common case - change any that apply to your situation. If you'd rather not fill this in, your admin or our team can complete it from your intake answers.
Sunrise Residential CareFacility name
Applied ForApp./Lic. No.
Part I - wages and other income
1.Net Wages (specify source)
2.Net Wages (specify source)
3.Interest & Dividends
4.Other Income (specify)
5.Other Income (specify)
6.Total Income$0.00
Personal expenses
7. Residence type
Mortgage
Rent
Live in Facility
Residence cost
8.Utilities (Electric, Oil/Gas, Water, Telephone)
9.Insurance (Homeowners, Property, Life, Medical, Vehicle)
10.Taxes (Real Property, Personal Property)
11.Transportation
12.Medical Expense
13.Dental Expense
14.Groceries
15.Clothing
16.School Tuition
17.Alimony / Child Support
18.Travel and Entertainment
19.Other
20.Total Personal Expenses$0.00
21.Difference (Income minus Expenses)$0.00
LIC 401a Part I must be completed separately by every sole proprietor and general partner - not once for the whole business. We've generated one form per partner from your ownership list on A1.
Owner 1
Form 1 of 2
Part II - to be completed by all applicants/licensees and each general partner
This section is shared across the whole business, regardless of which mode above applies - it's not repeated per partner.
YesNo
YesNo
Rented
Leased
Purchased
Identify the owner(s) of the facility property and phone number(s)
•
A8b - LIC 403 Balance Sheet
Review your numbers - totals calculate automatically
85%
Enter your figures below - every total calculates itself as you type, and your answers save automatically as you go. If you'd rather not fill this in, your admin or our team can complete it from your intake answers.
The official LIC 403 form requires LIC 403a to be attached. We don't have that document yet - once it's added, this form will reflect it. For now, this won't block the rest of your package.
Sunrise Care Holdings LLCFrom your business info (A1)
Applied ForApp./Lic. No.
Sunrise Residential CareFacility name
Current assets
1.Cash on Hand
2.Cash in Financial Institutions
3.CD's & Other Like Accounts
4.Short-Term Receivables & Notes
5.Stocks & Bonds
6.Other Current Assets
7.Total Current Assets$0.00
Long-term assets
8.Real Property
9.Land (other than included above)
10.Improvements
11.Equipment
12.Furniture & Fixtures
13.Other Long-Term Asset
14.Other Long-Term Asset
15.Other Long-Term Asset
16.Other Long-Term Asset
17.Total Long-Term Assets$0.00
18.Total Assets$0.00
Liabilities
19.Credit Accounts (open, revolving, installment)
20.Salaries & Wages Payable
21.Taxes Payable
22.Other Payables
23.Mortgages
24.Auto Loans
25.Equipment Loans
26.Other Notes Payable
27.Total Liabilities$0.00
Equity
28.Equity$0.00
•
A8c - LIC 403a Balance Sheet Supplemental Schedule
Itemized backup for your A8b balance sheet
90%
This schedule itemizes the figures summarized on your A8b balance sheet - list each account, property, or loan individually. Everyone (you, your admin, or our team) can fill this in, and it saves automatically as you go. These totals are tracked separately from A8b's totals, so update both if a number changes.
Sunrise Care Holdings LLCFrom your business info (A1)
Applied ForApp./Lic. No.
Current assets
Cash in checking accounts
Total (transfer to LIC 403, line 2)$0.00
Savings, CDs & other like accounts
Total (transfer to LIC 403, line 3)$0.00
Short-term receivables & notes
Total (transfer to LIC 403, line 4)$0.00
Stocks & bonds
Total (transfer to LIC 403, line 5)$0.00
Other current assets
Total (transfer to LIC 403, line 6)$0.00
Long-term assets
Real property
Total current value (transfer to LIC 403, line 8)$0.00
Land
Total current value (transfer to LIC 403, line 9)$0.00
All other long-term assets
Total current value (transfer to LIC 403, line 13)$0.00
Liabilities
Credit accounts (open, revolving, installment)
Total balance due (transfer to LIC 403, line 19)$0.00
Taxes payable
Total balance due (transfer to LIC 403, line 21)$0.00
Other payables
Total balance due (transfer to LIC 403, line 22)$0.00
Mortgages
Total balance due (transfer to LIC 403, line 23)$0.00
Auto loans
Total balance due (transfer to LIC 403, line 24)$0.00
Equipment loans
Total balance due (transfer to LIC 403, line 25)$0.00
Total combined monthly payments, all categories
$0.00
•
A9 - LIC 404 Financial Information Release and Verification
Authorizes your bank to release info to the licensing agency
95%
You only need to complete Part I below - it's your authorization letting the bank share account information with the licensing agency. Parts II and III are filled in later by the licensing agency and your bank, not by you, so we've shown them grayed out just so you know what the rest of this form looks like. A separate LIC 404 is needed for each bank you do business with - for now this covers one bank; let us know if you need to add another.
Part I - to be completed by applicant(s)
Maria Torres, James TorresFrom A1 ownership list
This authorization is valid for up to one year from the date of your signature below.
Every applicant listed above signs separately
Proof of financial reserves
This isn't part of LIC 404 itself - it's additional supporting documentation we collect alongside it. Licensing review wants confidence that your facility can keep operating through a slow period, so we ask new applicants to show liquid reserves covering at least three months of operating expenses, demonstrated through your own recent bank statements.
$0.00 × 3 = $0.00 minimum reserve target3 months of Total Operating Costs, from A7/LIC 401 line 37
Drop your recent bank statement(s) here
PDF, JPEG, or PNG · most recent 1-3 months recommended
This can be the same account you authorized for release above, or a separate account - whatever best demonstrates your available reserves.
🔒 Part II - completed by licensing agency, not by you
To (bank name & address)-
From (licensing agency name & address)-
🔒 Part III - completed by your bank or financial institution, not by you
Current status of accounts (balances, dates opened)-
Outstanding loans, lines of credit-
Applicant's payment history-
Signature of bank official-
Once you sign Part I, we'll send this form directly to your bank - this section doesn't hold up the rest of your package.
✓
A10 - LIC 500 Personnel Report
Maintained by your team - view your roster anytime
100%
Your staffing schedule is built and kept current by our team, based on your facility's capacity. As a customer, you don't need to edit this yourself - review it below anytime, and if anything needs to change, let our team know. The add/remove controls below are for our team to use when updating the roster.
Sunrise Residential CareFacility name
RCFEFacility type
Applied ForFacility number
Section A - staff subject to criminal background check requirements
Required under Sections 1522, 1568.09, 1569.17, and 1596.871 of the Health and Safety Code, prior to employment, residence, or initial presence in the facility.
| Name | Date Empl'd | Job Title | Shift 1 - days & hours | Shift 2 - days & hours | |||||
|---|---|---|---|---|---|---|---|---|---|
| Days | From | To | Days | From | To | ||||
Section B - staff exempt from criminal background check requirements
By signing below, the licensee or designated representative verifies they believe the listed persons are exempt under statute.
| Name | Date Empl'd | Job Title | Shift 1 - days & hours | Shift 2 - days & hours | |||||
|---|---|---|---|---|---|---|---|---|---|
| Days | From | To | Days | From | To | ||||
•
A11 - LIC 501 Personnel Record
One required for every owner · 0 of 2 started
0%
Like LIC 215, this personnel record must be completed separately by every owner - not once for the whole business. We've generated one form per owner from your A1 ownership list. Each owner can fill in their own, or your admin can complete it on their behalf.
Owner 1
Form 1 of 2
•
A12 - LIC 503 Health Screening Report
One required for every owner · 0 of 2 started
0%
Like LIC 215 and LIC 501, this health screening must be completed separately for every owner - we've generated one per person from your A1 ownership list. You complete the top section and sign the release; the clinical evaluation below has to come from an actual physician, so that part stays pending until they complete it.
Owner 1
Form 1 of 2
•
A13 - LIC 508 Criminal Record Statement
One required for every owner · 0 of 2 started
0%
This is a required form with no changes permitted to its wording - every owner answers it personally, exactly as printed. We've generated one per person from your A1 ownership list. The two disclosure questions below have no pre-selected answer; you must choose Yes or No yourself.
Owner 1
Form 1 of 2
•
A14 - LIC 610E Emergency and Disaster Plan
Review your facility's emergency plan
99%
This plan must be reviewed annually and signed by the licensee or administrator. We've started the procedural sections with proven starting language you can edit freely. Sections marked "Example only" depend on your facility's exact location and aren't real defaults yet - replace them with your actual local information.
Sunrise Residential Care - Applied ForFacility & license number
Maria TorresAdministrator
412 Harbor Way, Sacramento, CA 95814Facility address
(916) 555-0142 · Alt: (916) 640-9105From A1
Emergency names and telephone numbers
Example only - not your real local numbers yet
Once location lookup is wired up, this section will be filled automatically based on your facility's city and county. For now, replace each number with your actual local contact.
Assignments during an emergency or disaster
+ Add assignment
Resident information (readily available to staff during an emergency)
Utility shut-off
Facility exit doors
+ Add exit door
Resident assembly points
Temporary shelter locations
Example only - within 10-25 miles of a Sacramento facility
At least two shelter locations are required, with one outside the immediate area. Once maps-based lookup is wired up, this will search automatically near your facility's actual address.
Sheltering in place & self-reliance
Include your plan for utility outages (water, sewer, gas, electricity).
Evacuation procedures
Emergency and disaster procedures
Administrator statement
As licensee or administrator of this facility, I assume responsibility for and have reviewed this plan for providing emergency services, and as necessary, have updated it to reflect any changes in the facility that affect this plan, as indicated below. I shall instruct all residents, age and abilities permitting, any staff and/or household members as needed on their duties and responsibilities under this plan.
+ Add review entry
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A15 - LIC 999 Facility Sketch
Awaiting your photos & measurements
facility_sketch_responsible_party - set automatically based on which package you purchased. Shown here so you can preview both states.
Regnexify draws it
You provide it
⚠️
This document can't be completed automatically. A real person on our team draws your floor plan and yard sketch by hand from photos, video, and measurements you provide - there's no way to automate this one.
1
Awaiting materials from you
2
Human is sketching
3
Sketch ready for your review
4
Done
Sunrise Residential CareFacility name
412 Harbor Way, Sacramento, CA 95814Address
Photos and a walkthrough video of every room (label what each room is used for), measurements of each room, and the same for your yard - buildings, walkways, driveways, fences, gates, and anything like a pool, garbage storage, or animal pen.
Drop your photos, video, or measurement files here
PDF, JPEG, PNG, or common video formats
⏱️ The timeline for this document depends entirely on how quickly you provide everything we need. The faster you upload your photos, video, and measurements, the faster our team can complete your sketch - there's no fixed turnaround time on our side once we have what we need from you.
Your package doesn't include the Facility Sketch - you (or your architect/contractor) are responsible for providing it. CDSS still requires it as part of your application: a full floor plan with every room labeled by use, plus your yard showing buildings, walkways, driveways, fences, gates, and anything like a pool, garbage storage, or animal pen.
We don't review, correct, or vouch for this sketch - it's stored here only for your own convenience, alongside the rest of your package.
Drop your finished facility sketch here
PDF, JPEG, or PNG
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A16 - LIC 9054 Local Fire Inspection Authority Information
Identifies who will conduct your fire safety inspection
60%
The licensing agency uses this to obtain your fire safety inspection and clearance from the correct local authority. Return this with your completed application.
Maria TorresApplicant name
Jun 16, 2026Today's date
Sunrise Residential CareFacility name
412 Harbor Way, Sacramento, CA 95814Facility address
Once location lookup is wired up, this will be filled automatically based on your facility's city and county. For now, enter your actual local fire authority - it saves automatically.
You purchased Section A only. Sections B, the Preliminary package, and the Supplemental package are not part of this order - you can add any of them anytime from your account.
Your document
Section A - applicant & facility
In progress · PDF available once complete
Hospice waiver request
Standalone document · no specialist tracker stages apply
45%
Your document is being drafted by our team. We'll notify you once it's ready for specialist review.
✓ Delivered digitally
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