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LIC 308: Designation of Facility Responsibility

By Sevana Care · Checked against cdss.ca.gov and Title 22 on

When it is due
With the license application: CDSS's application instructions (LIC 281, 11/25) list it as item A3 and mark it required for an RCFE [3].After that, you notify the licensing agency in writing "within 10 days of any change in the above authorization" [1].
Who fills it out
The licensee signs, and names staff [1]."A LICENSEE CANNOT DESIGNATE HIM OR HERSELF," and "More than one staff person may be designated on a form" [3]. A corporation or limited liability company submits a resolution with it [3].
Where it is kept
The form does not say where a copy is kept [1].CDSS's list of records an RCFE keeps, LIC 311F (4/05), does not name it [6].
How long to keep
The form gives no retention period, and the application instructions set none [1][3].

LIC 308 is the California Department of Social Services (CDSS) form "Designation of Facility Responsibility" [1][2]. The licensee uses it to name the staff who will receive "any documents including reports of inspections and consultations, accusations and civil and administrative processes" at the facility when the licensee is absent [1]. CDSS's application instructions for a facility license list it as item A3 [3]. They say a licensee cannot name themselves [3].

The form tells an RCFE to comply with Title 22 "Section 87564" [1]. Title 22 renumbered that section as § 87405 in 2008 [4][7].

Who signs it, and who you can name

The licensee fills it out and signs it. The top asks for the facility name, date, facility number, address, phone, city and county. The sentence "In the event of my absence I designate" has a blank for the name of the person. The signature line reads "Signature of applicants/licensees," with lines for title, address, city, county and zip [1].

The form says licensees "shall use this form to delegate the above authority to appropriate staff" [1]. Under item A3, the LIC 281 application instructions say [3]:

  • "At least one individual must be designated as the authorized person of the facility to act in the licensee's absence." Then: "A LICENSEE CANNOT DESIGNATE HIM OR HERSELF."
  • "More than one staff person may be designated on a form."
  • "If the applicant is a corporation or a limited liability company, a resolution must authorize the delegation and be submitted with this form." The form itself says applicants and licensees who are corporations "shall attach board resolutions authorizing this delegation" [1].
  • "The form must contain the original signatures of the applicants/licensees. The licensing agency will not accept photocopied signatures on this form."

The form says "appropriate staff," and the A3 instructions add no further test for who qualifies [1][3].

When you file it

With the license application. LIC 281 is CDSS's application instructions for a facility license. Its forms table lists LIC 308 as item A3 and marks it required for an RCFE [3].

After a change. The form says: "I (We) shall notify the licensing agency, in writing, within 10 days of any change in the above authorization" [1]. It says "10 days" and does not say whether they are calendar or working days. It does not say whether to send a new LIC 308 or a letter [1].

How it fits with the 24-hour rule

Three texts speak to who must be at the home. The form says licensed facilities "are required to have an authorized person continuously present at the facility during operational hours to represent the facility and to accept licensing reports" [1].

Health and Safety Code § 1569.618(b) says: "At least one administrator, facility manager, or designated substitute who is at least 21 years of age and has qualifications adequate to be responsible and accountable for the management and administration of the facility pursuant to Title 22 of the California Code of Regulations shall be on the premises 24 hours per day." It adds that "The designated substitute may be a direct care staff member who shall not be required to meet the educational, certification, or training requirements of an administrator" [5].

Title 22 § 87405(a) says: "When the administrator is not in the facility, there shall be coverage by a designated substitute who shall have qualifications adequate to be responsible and accountable for management and administration of the facility as specified in this section" [4].

The form calls its person the "authorized person." The statute names an "administrator, facility manager, or designated substitute," and the regulation names a "designated substitute." The form does not use the words "designated substitute," and neither the statute nor the regulation mentions LIC 308 [1][4][5]. We found no source that says the person you name on LIC 308 is your designated substitute, or that the substitute must be named on LIC 308. If you need that answer for your home, ask your licensing analyst.

The section number on the form is out of date

The form says: "When delegating authority to appropriate staff, Residential Care Facilities for the Elderly shall comply with CCR Title 22, Division 6 Section 87564" [1].

Westlaw's page for § 87564 is headed "[Renumbered]," and its history reads "renumbering former section 87564 to new section 87405 filed 3-5-2008" [7]. The history of § 87405 says the same [4]. The form is dated 11/02, and CDSS's forms list still shows that date [1][2]. Read the form's "Section 87564" as § 87405. The designated substitute sentence is in subsection (a) [4].

Questions

Can I name myself on LIC 308?

No. CDSS's application instructions say "A LICENSEE CANNOT DESIGNATE HIM OR HERSELF" [3]. The form asks the licensee to delegate the authority "to appropriate staff" [1].

Who can I name on LIC 308?

The form says licensees use it "to delegate the above authority to appropriate staff" [1]. The instructions say at least one individual must be designated, and "More than one staff person may be designated on a form" [3]. Neither text defines "appropriate staff."

When do I have to file or update LIC 308?

You file it with the license application, where LIC 281 lists it as item A3 [3]. After that, the form says to notify the licensing agency in writing "within 10 days of any change in the above authorization" [1].

Does a corporation or LLC need to attach anything to LIC 308?

Yes. The form says corporations "shall attach board resolutions authorizing this delegation" [1]. The instructions say that for a corporation or a limited liability company, "a resolution must authorize the delegation and be submitted with this form" [3].

Can I send a photocopy of LIC 308?

Not with photocopied signatures. The instructions say "The form must contain the original signatures of the applicants/licensees. The licensing agency will not accept photocopied signatures on this form" [3].

Is the person on LIC 308 the same as the designated substitute?

We found no source that says so. Title 22 § 87405(a) requires "coverage by a designated substitute" when the administrator is not in the facility [4]. Health and Safety Code § 1569.618(b) requires an administrator, facility manager or designated substitute on the premises 24 hours per day [5]. The form names an "authorized person" and does not use the words "designated substitute" [1].

Why does LIC 308 cite Section 87564?

The form is dated 11/02 [1]. Title 22 renumbered former § 87564 as § 87405 in a change filed 3-5-2008 [4][7].

Does LIC 311F list LIC 308?

No. CDSS's records list for RCFEs, LIC 311F, is dated 4/05 and does not name LIC 308 [6].

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Sources

  1. CDSS, LIC 308 (11/02), Designation of Facility Responsibility (PDF)
  2. CDSS, Forms and Publications (I-L)
  3. CDSS, LIC 281 (11/25), Application Instructions for a Facility License (PDF)
  4. California Code of Regulations, Title 22, § 87405, Administrator, Qualifications and Duties (Westlaw)
  5. California Health and Safety Code § 1569.618, administrator and substitute on the premises (Legislative Information)
  6. CDSS, LIC 311F (4/05), Records To Be Maintained At The Facility, Residential Care Facility For The Elderly (PDF)
  7. California Code of Regulations, Title 22, § 87564, Administrator, Qualifications and Duties [Renumbered] (Westlaw)