Skip to content
Sevana
Book a demo

Forms library

LIC 405: Record of Client's/Resident's Safeguarded Cash Resources

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

When it is due
The rule sets no number of days.It says "Each accounting shall be kept current," and the form says to date each transaction and use a separate line for each [3][1]. The form and the rule speak of homes that handle or hold a resident's cash [1][3].
Who fills it out
The home keeps it.The form has two signature columns on every line: a facility representative and the resident or the resident's representative [1]. Title 22 says a licensee "shall not be required to handle residents' cash resources" [3].
Where it is kept
Section 87506(b)(16) puts "Records of resident's cash resources as specified in Section 87217" in the resident's record, kept in the facility or at a central administrative location readily available to facility staff and licensing staff [4].CDSS's list, dated 4/05, puts the form under "Residents Records" [5].
How long to keep
Section 87506(e) sets a minimum of three years after service to the resident ends for original records [4].Neither § 87217 nor the form gives its own period [3][1].

LIC 405 is the California Department of Social Services (CDSS) Record of Client's/Resident's Safeguarded Cash Resources. The form says: "Facilities that handle client's/resident's cash resources must maintain accurate records of all money received and disbursed" [1]. For an RCFE, Title 22 § 87217(g)(1) says records of resident cash kept "as a drawing account" must "include a ledger accounting (columns for income, disbursements and balance) for each resident, and supporting receipts filed in chronological order" [3]. Section 87217 names no form [3]. CDSS lists LIC 405 in the records an RCFE keeps [5].

Who fills it out

The licensee keeps the record, and only when the home holds resident cash. Section 87217(a): "A licensee shall not be required to handle residents' cash resources. However, if a resident incapable of handling his own cash resources, as documented by the initial or subsequent appraisal, is accepted for care, his cash resource shall be safeguarded in accordance with the regulations in this section" [3]. Section 87217(c) says every facility "shall account for any cash resources entrusted to the care or control of the licensee or facility staff" [3].

Each ledger line has two signatures [1]:

  • the facility representative. The form says this signature "is necessary to be able to verify a cash transaction."
  • the client/resident or representative. The form says this signature "indicates you have received" the amount "from the facility on the date indicated."

The top of the form asks for the resident's name, the facility number and the year [1].

Section 87217(b) says the licensee "shall give the residents receipts for all such articles or cash resources" [3].

Surety bond. Title 22 § 87216(a): "Each licensee, other than a county, who is entrusted to safeguard resident cash resources, shall file or have on file with the licensing agency a copy of a bond issued by a surety company to the State of California as principal" [8]. Section 87216(d): "No licensee shall either handle money of a resident or handle amounts greater than those stated in the affidavit submitted by him or for which his bond is on file without first notifying the licensing agency and filing a new or revised bond as required by the licensing agency" [8]. CDSS's list names "Surety Bond (LIC 402)" [5].

When it is due

The rule sets no number of days. Section 87217(g)(1) says "Each accounting shall be kept current" [3]. The form says to note the date of the transaction and to use a separate line for each one [1].

Cash kept away from the home. Section 87217(h): "Immediately upon admission," resident cash entrusted to the licensee and not kept in the licensed facility goes into a bank, savings and loan or credit union account [3]. That account is kept apart from the licensee's own accounts, its title notes that it is residents' money and the resident has access to the money "upon demand to the licensee" [3]. Cash kept on the premises "shall be kept in a locked and secure location" [3].

When a resident leaves or dies. On discharge, the cash is surrendered to the resident or the responsible person, and "A signed receipt shall be obtained" [3]. On death, cash resources "shall immediately be safeguarded," and § 87217(j) says who is notified and who receives them [3].

Change of licensee. Section 87217(k)(2) asks for an accounting of residents' cash resources "on a form provided or approved by the Department." The section does not name LIC 405 for it [3].

Where it is kept

CDSS lists "Record of Client's/Resident's Safeguarded Cash Resources (LIC 405)," with the supporting receipts, under "Residents Records." CDSS says these records "must be kept in the facility complete and current, and readily available for review" [5]. The same list names "A savings and/or checking account for resident's cash resources, if not kept in the facility" [5]. That list is dated 4/05. The current rule is § 87506.

Section 87506(a) requires a record for each resident, in the facility or at a central administrative location readily available to facility staff and licensing staff. Item (b)(16) names the cash records [4]. The form says supporting receipts for purchases "shall be filed in order of dates of purchases" [1].

How long to keep it. Section 87506(e): "Original records or photographic reproductions shall be retained for a minimum of three (3) years following termination of service to the resident" [4]. Section 87217 and the form give no separate period [3][1].

Resident records are confidential, and the licensee is responsible for storing them [4].

What the record must show

  • The ledger columns. The rule asks for columns for income, disbursements and balance [3]. The form has columns for amount received, "amount spent or withdrawn" and balance, plus date and description [1].
  • A receipt for cash given to the resident. Section 87217(g)(1)(A) says an acceptable receipt "includes: the resident's signature or mark, or responsible party's full signature, and a statement acknowledging receipt of the amount and date received." For a purchase made from the resident's account, the store receipt is the acceptable receipt [3].
  • A copy of the receipt for cash held for safekeeping. Section 87217(g)(2): the records "shall include a copy of the receipt furnished to the resident," and the receipt given to the resident "shall be original and include the resident's and/or his responsible person's signature" [3].
  • Bank records. Section 87217(g)(3) adds "Bank records for transactions of cash resources deposited in and drawn from the account" [3].
  • What counts as cash. "Cash resources include but are not limited to monetary gifts, tax credits and/or refunds, earnings from employment or workshops, and personal and incidental need allowances from funding sources such as SSI-SSP" [3].
  • Kept apart. Resident cash held for safekeeping "shall not be commingled with or used as the facility funds or petty cash" [3]. The same subsection says it "does not prohibit the licensee from providing advances or loans to residents from facility money" [3].

Limits on a licensee who holds resident cash

  • No spending on basic services. No licensee or employee shall make expenditures from residents' cash "for any basic service specified in this Chapter," or for any basic service in the admission agreement, except where the licensee is the resident's Social Security representative payee [3].
  • Roles the licensee may not take. Section 87217(d): except under approved continuing care agreements, no licensee or employee of a facility shall accept appointment as a guardian or conservator of a resident, accept a general or special power of attorney for a resident, become substitute payee for any payments, or become a joint tenant with a resident on an account under § 87217(h). The substitute-payee rule "does not apply to a licensee who is appointed by the Social Security Administration as representative payee for the resident" [3].
  • Gifts to the licensee. "All monetary gifts, and any gift exceeding an estimated value of $100," given to a licensee by or for a resident "shall be recorded" [3]. The rule "shall not include monetary gifts or valuables given by the friends or relatives of a deceased resident" [3].

Other cash forms on the CDSS list

From the CDSS forms list [2]:

  • LIC 406 (5/13), Client/Resident Cash Sheet: the form says the licensee is not required to use it [6].
  • LIC 405 MFHV, Record of Veteran Resident's Safeguarded Cash Resources: for Medical Foster Homes for Veterans. Its text cites the MFHV Written Directives [7].

Questions

Does an RCFE have to use LIC 405?

Section 87217 names no form [3]. CDSS's list says the records on it are "required under specific sections of Title 22," and it names LIC 405 [5]. The form says facilities that handle resident cash "must maintain accurate records" [1].

Does a home have to hold a resident's money?

No. Section 87217(a): "A licensee shall not be required to handle residents' cash resources." But a home that accepts a resident who cannot handle his or her own cash, as an appraisal documents, must safeguard that cash [3]. Sections 87217(b) and (c) apply to any cash a resident entrusts to the home or its staff [3].

What is the difference between LIC 405 and LIC 406?

LIC 406 is titled "Client/Resident Cash Sheet" and says "Licensee is not required to use this form." It has one "Cash Amount" column and no balance column [6]. Section 87217(g)(1) asks for columns for income, disbursements and balance [3]. CDSS's RCFE records list names LIC 405 and does not name LIC 406 [5]. We can't say whether a LIC 406 meets § 87217(g)(1).

Why does the form cite section numbers that do not match the rule?

The form's instruction 4 cites "Sec. 80026(h)(1)(A) and 87227(g)(1)(A)" [1]. The RCFE rule that was § 87227 is now § 87217, renumbered in 2008 [3]. The receipt text the form points to is now § 87217(g)(1)(A) [3]. We did not check § 80026, which the form also cites.

How Sevana Care keeps this record

Handling a resident's money adds a record-keeping job. Sevana Care's inspection checklist has a section for resident funds. It asks about a separate ledger for each resident whose funds you handle, and about receipts for every disbursement made on a resident's behalf. You mark each one checked, and the row shows when it's next due. We don't keep the LIC 405 ledger or print it. Find Resident funds systems under Inspections in the sample home.

Sources

  1. CDSS, LIC 405 (8/01), Record of Client's/Resident's Safeguarded Cash Resources (PDF)
  2. CDSS, Forms and Publications (I-L)
  3. California Code of Regulations, Title 22, § 87217, Safeguards for Resident Cash, Personal Property, and Valuables (Westlaw)
  4. California Code of Regulations, Title 22, § 87506, Resident Records (Westlaw)
  5. CDSS, LIC 311F (4/05), Records To Be Maintained At The Facility, Residential Care Facility For The Elderly (PDF)
  6. CDSS, LIC 406 (5/13), Client/Resident Cash Sheet (PDF)
  7. CDSS, LIC 405 MFHV, Record of Veteran Resident's Safeguarded Cash Resources (PDF)
  8. California Code of Regulations, Title 22, § 87216, Bonding (Westlaw)