LIC 625 — Appraisal/Needs and Services Plan
LIC 625 is the Appraisal / Needs and Services Plan — the document that says what care the facility will actually deliver, how often, and by whom. It is the single most-reviewed care document in an RCFE file.
Official PDF
The current LIC 625 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 625 on cdss.ca.govWho completes it and when
The administrator or designated staff, with the resident and, where appropriate, family and physician.
Completed at admission and updated as needs change.
How to complete LIC 625
- 1Start from the LIC 602A medical assessment and the LIC 603A appraisal so the plan matches documented needs.
- 2Write each need as a specific service with a frequency — 'two-person assist with transfers, every transfer' rather than 'assist with mobility'.
- 3Identify who provides each service, including outside providers such as hospice or home health.
- 4Have the resident or representative participate and sign.
- 5Review and update after any change in condition, fall, hospitalization, or medication change, and keep prior versions.
Mistakes evaluators flag
- A plan written at admission and never updated, while the care notes describe a very different resident.
- Services described without frequency, which makes it impossible to show they were delivered.
- Outside providers delivering care that appears nowhere in the plan.
Questions about LIC 625
How often should the Needs and Services Plan be updated?
Update it whenever the resident's condition or service needs change, and review it periodically even when nothing has changed so the file reflects current care.
Who has to sign the Needs and Services Plan?
The facility representative signs, along with the resident or their representative, documenting that the plan was developed with them.
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.