LIC 9020A — Register of Facility Residents — Residential Care Facilities for the Elderly
LIC 9020A is the register of facility residents — the current roster an evaluator asks for at the start of an inspection.
Official PDF
The current LIC 9020A 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 9020A on cdss.ca.govWho completes it and when
The administrator or office staff who process admissions and discharges.
Maintained continuously and produced at inspection.
How to complete LIC 9020A
- 1Add each resident on the day of admission with the required identifying details.
- 2Record discharges, transfers, and deaths with dates as they occur.
- 3Reconcile the register against occupancy monthly.
- 4Keep it accessible so it can be produced immediately at entrance.
Mistakes evaluators flag
- A register that shows more residents than the facility is licensed for because discharges were never recorded.
- Roster rebuilt from memory at inspection time.
Questions about LIC 9020A
When is the resident register requested?
It is typically requested at the beginning of an inspection, so it should be current and immediately available.
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.