Operational
LIC 623 — Group Planned Activities
LIC 623 documents the group activities a facility plans and offers. It shows an evaluator that the activity program described at admission is actually running.
Revision 5/01SituationalSource verified 2026-08-20
Official PDF
The current LIC 623 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 623 on cdss.ca.govWho completes it and when
The activity coordinator or administrator.
Maintained monthly.
How to complete LIC 623
- 1Build the month's activity calendar before the month starts.
- 2Record the activity, date, and time as offered.
- 3Note participation so the record reflects what actually happened.
- 4Keep completed months on file rather than discarding last month's calendar.
Mistakes evaluators flag
- A calendar posted for residents but never retained as a record.
- Identical activities copied forward month after month with no evidence they occurred.
Questions about LIC 623
How long should activity records be kept?
Keep completed monthly records on file so they can be produced during an inspection covering that period.
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 operational 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.