LIC 621 — Client/Resident Personal Property and Valuables
LIC 621 is the inventory of a resident's personal property and valuables. It protects both the resident and the facility by recording exactly what came in, what changed, and what left with the resident.
Official PDF
The current LIC 621 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 621 on cdss.ca.govWho completes it and when
A staff member together with the resident or responsible party.
Completed at admission and updated when property changes.
How to complete LIC 621
- 1Inventory belongings on move-in day, in the resident's presence, before items are unpacked.
- 2Describe valuables specifically — brand, color, distinguishing marks — instead of writing 'jewelry'.
- 3Both parties sign and date the initial inventory.
- 4Add a dated line whenever property is brought in, removed, or destroyed, with signatures.
- 5Reconcile and sign the inventory again at discharge or upon death when property is released.
Mistakes evaluators flag
- Vague single-line entries that cannot be matched to an actual item later.
- Property released to family with no signature on the form.
- The inventory never updated after the first week of admission.
Questions about LIC 621
What happens to the inventory at discharge?
The inventory is reconciled and signed when property is returned, so there is a dated record of what the resident or family received.
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.