Try for free

California LIC 602 Physician's Report, Community Care

California community care facilities, such as adult residential facilities and group homes, provide nonmedical care and must know whether a resident or applicant is appropriate for that setting. On the LIC 602 the physician gives diagnoses, TB status, contagious diseases and allergies, ambulatory status for fire clearance, physical and mental health, capacity for self-care, and the prescription and as-needed over-the-counter medications the facility may give.

Who completes it

The physician completes the diagnosis and examination sections through the signature on page 4. The licensee fills in facility information, the resident or representative supplies resident details, and the authorized representative signs the release to the licensing agency.

Submitting and payment

How to submit it
Give the completed report to the facility licensee for the resident's file.
Who pays
The form sets no fee and does not say who pays for the physician's report.

Good to know

  • The form reminds physicians that these facilities do not provide professional nursing care and asks directly whether the person requires skilled nursing care.
  • Ambulatory status uses fire clearance definitions: a person who cannot transfer to and from bed independently counts as nonambulatory, and one needing help to turn in bed as bedridden.
  • Physicians list over-the-counter medications the facility may give as needed for headache, constipation, diarrhea, indigestion and other named conditions.
  • Residential care facilities for the elderly use LIC 602A instead of this form.

Get the official form

Download the current version from the source each time; forms change without notice.

Physician's Report for Community Care Facilities

Official pagePDF

How this list is checked

A form is listed only after its name and number were confirmed on the issuing agency’s or insurer’s own website, or in the form itself. Each entry links to that source. The list was last checked in October 2026. Forms and their requirements change without notice, so check the official page for the current version before you complete one.

Vero is not affiliated with, or endorsed by, the agencies and insurers listed here. Read our editorial policy.

Frequently asked questions

What is the difference between LIC 602 and LIC 602A?

LIC 602 is for residents and applicants of community care facilities, such as adult residential facilities and group homes. Residential care facilities for the elderly (RCFEs) use LIC 602A instead. Child care centers use a different form, LIC 701.

How does the LIC 602 define nonambulatory?

A person unable to leave a building unassisted under emergency conditions, including anyone who cannot respond to an approved fire alarm signal or oral instruction, or who depends on crutches, walkers or wheelchairs. A person who cannot transfer to and from bed independently is also considered nonambulatory for fire clearance.

Does the LIC 602 need a TB test?

It asks for the person's tuberculosis status (active, inactive or none), the date and type of the last TB test, and any treatment or medication. It also asks about other contagious or infectious diseases and allergies, with treatment for each.