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LIC 602A: Medical Assessment for Residential Care Facilities for the Elderly

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

When it is due
Before you accept the person as a resident.The assessment must be made within the last year, and updated when the Department requires it [2].
Who fills it out
A licensed medical professional completes and signs it.The licensee or designee fills out Part I, and the resident or a legal representative Parts II and III [1][2].
Where it is kept
In the resident's record, kept "in the facility or in a central administrative location readily available to facility staff and to licensing agency staff" [4].
How long to keep
At least 3 years after the resident's service ends [4].

LIC 602A is the California Department of Social Services (CDSS) form for the medical assessment [1]. Title 22 requires the assessment before an RCFE accepts a person as a resident [2]. A licensed medical professional completes and signs it, and the assessment must be made within the last year [2]. The form used to be called the Physician's Report for Residential Care Facilities for the Elderly [3].

Who fills it out

Three people fill out different parts of the nine pages [1]:

  • The licensee or designee fills out Part I, the facility information.
  • The resident, or the resident's legal representative, fills out Part II and signs Part III. Part III authorizes the release of the medical information to your facility. CDSS also lists a separate form, LIC 605A, titled "Release Of Client/Resident Medical Information" [7].
  • A licensed medical professional fills out Parts IV and V and signs. Title 22 says the assessment is "signed by a licensed medical professional acting within the scope of their practice" [2]. CDSS names a physician, a physician assistant and a nurse practitioner as examples of licensed medical professionals [6].

The 2025 update removed the word "physician" from the form so that other licensed medical professionals can complete it [3].

When it is due

Before the person is accepted as a resident. The assessment must be "made within the last year" [2].

Example: the exam is done and signed on March 3, 2026 and the resident is accepted on November 20, 2026. That is 8 months and 17 days, so the assessment is inside the year. If the same resident were accepted on April 6, 2027, the exam would be 13 months old and you would need a new one.

The rule does not say whether the year counts from the exam date or the signature date.

You also need a new medical assessment "when required by the Department" [2].

Where it is kept

In the resident's record. Title 22 lists "reports of the medical assessment" among the contents of that record [4]. The record stays in the facility, or in a central administrative location that facility staff and licensing staff can both reach [4].

  • The record is confidential. Apart from licensing's right to inspect it, you share it only with the written consent of the resident or the designated representative [4].
  • Licensing can inspect, audit and copy it on demand during normal business hours [4].
  • Keep the original, or a photographic reproduction, for at least 3 years after the resident's service ends [4]. Example: if a resident leaves on June 30, 2026, keep the file through at least June 30, 2029.

What the record must show

Section 87458 sets what the assessment must contain [2]:

  • Signed by a licensed medical professional, made within the last year and in the record before the person is accepted.
  • A physical examination with a diagnosis, plus results of an exam for communicable tuberculosis, infectious diseases, contagious diseases and other medical conditions.
  • Prior medical services and history, and current medical status including height, weight and blood pressure.
  • The current prescribed medications, with an indication of whether each should be centrally stored.
  • Physical limitations, including any medically necessary diet limits.
  • Whether the person is ambulatory, nonambulatory or bedridden. For a nonambulatory person, whether that comes from the physical condition, the mental condition, or both.
  • Cognitive conditions, such as mild cognitive impairment and major neurocognitive disorder.
  • A description of any known behavioral expression.
  • Information that applies to your pre-admission appraisal.

The list says "include, but not be limited to", so the assessment may hold more [2].

Questions

Is LIC 602 the same as LIC 602A?

No. CDSS lists two separate forms: "LIC 602 (7/22) - Physician's Report For Community Care Facilities" and "LIC 602A (4/26) - Medical Assessment for Residential Care Facilities for the Elderly" [7]. Section 87458 names no form number [2]. None of the sources here says one replaces the other, or whether an RCFE may use LIC 602.

How recent does the assessment have to be?

Within the last year, and you need it before the person is accepted as a resident. Section 87458(a) says the licensee must obtain it "prior to a person's acceptance as a resident" and that it must be "made within the last year" [2]. CDSS repeats this in its dementia care FAQ [6]. Title 22 does not say whether the year counts from the exam date or the signature date.

Do I need a new LIC 602A for every resident every year?

No. A medical assessment is required before acceptance and when the Department requires an updated one [2][6]. CDSS says the yearly assessment for residents with dementia was removed from Section 87705, and that the requirement of a medical assessment for every resident remains [6]. A separate rule, Section 87463(h), says you must request that each resident have an annual routine visit with a licensed medical professional. A visit summary goes in the record, and so does a refusal [5]. CDSS describes the annual routine visit and the medical assessment separately [6].

Do I have to use this exact form, and does the revision date matter?

Section 87458 does not name a form number or a revision [2]. It describes what the assessment must contain. CDSS calls LIC 602A a courtesy form [1][3]. It describes the updated form as a template that helps prospective residents, residents and licensees obtain a medical assessment that meets the requirements [3]. With questions about the form, CDSS tells licensees to contact their Adult and Senior Care Regional Office [3].

How Sevana Care keeps this record

Is the medical assessment signed and current? In Sevana Care, a scan of the LIC 602A won't save without the signer's name and the signed date. The LIC 602A counts in the check for missing documents. It shows Expiring in the last 30 days and Stale 12 months after the signed date. Those reminders are Sevana Care's own; Title 22 does not require a new medical assessment every year [2][6]. See the inspection check in the sample home.

More in Admission and the resident file

  • LIC 603A: The appraisal you complete before a resident moves in
  • LIC 9172: The checklist of what a new resident can do for themselves
  • LIC 625: A CDSS form you may use for the plan of action when a resident's need is not being met
  • LIC 604A: The CDSS guide for the admission agreement you sign with each resident
  • LIC 613C-2: The personal rights a resident signs at admission

Sources

  1. CDSS, LIC 602A (4/26), Medical Assessment for Residential Care Facilities for the Elderly (PDF)
  2. California Code of Regulations, Title 22, § 87458, Medical Assessment
  3. CDSS, PIN 25-05-ASC, Updated Medical Assessment for Residential Care Facilities for the Elderly (LIC 602A) Form, May 27, 2025 (PDF)
  4. California Code of Regulations, Title 22, § 87506, Resident Records
  5. California Code of Regulations, Title 22, § 87463, Reappraisals
  6. CDSS, Dementia Care in RCFEs and Miscellaneous Regulation Changes, Frequently Asked Questions, Version 2.0, August 2025 (PDF)
  7. CDSS, Forms and Publications (I-L), form titles