LIC 603A — Resident Appraisal
LIC 603A is the facility's own appraisal of what a resident can do and where they need help. It is the observational counterpart to the physician's medical assessment and it feeds directly into the Needs and Services Plan.
Official PDF
The current LIC 603A is published by the California Department of Social Services. We link to the live source rather than hosting a copy, so you always get the latest revision.
Open LIC 603A on cdss.ca.govWho completes it and when
The administrator or a designated staff member, based on direct observation and interview.
Completed by the facility at or before admission.
How to complete LIC 603A
- 1Review the physician's LIC 602A first so the appraisal is consistent with the medical record.
- 2Interview the resident and family about routines, preferences, and how much assistance is actually used day to day.
- 3Rate each area honestly, including mobility, bathing, dressing, eating, toileting, memory, and behavior.
- 4Write specific observations rather than one-word ratings — evaluators look for detail that supports the care plan.
- 5Sign, date, and use the appraisal to build or update the LIC 625 Needs and Services Plan.
Mistakes evaluators flag
- An appraisal that contradicts the physician's assessment with no note explaining why.
- Checkbox-only appraisals with no narrative to justify the level of service billed.
- Never reappraising after a fall, hospitalization, or clear change in condition.
Questions about LIC 603A
Is the appraisal the same as the Needs and Services Plan?
No. The appraisal records what the resident can and cannot do. The Needs and Services Plan (LIC 625) records what the facility will do about it.
Fill this form from data you already have
- Resident, staff, and facility details populate the form fields automatically.
- Track which forms are on file, which are missing, and which are about to expire.
- Incident reports draft the LIC 624 narrative and finalize an immutable PDF.
Related admission forms
RCFE OS is not affiliated with the California Department of Social Services. This guide is operational information for licensees, not legal advice. Always follow the current form instructions and guidance from your licensing analyst.