Physician's Report - LIC 602A Form
What It Is and Why Your Doctor Needs to Complete It
If your family is preparing to move a loved one into an assisted living, memory care, or board and care community in California, you will hear about the LIC 602A form early and often. It is one of the first documents a community will ask for, and it is one of the most common reasons a move-in date gets delayed.
This guide from Golden Pathways explains what the LIC 602A Physician's Report is, why the state of California requires it, why your loved one's doctor is the one who must complete it, and how to get it done without holding up the move.
What Is the LIC 602A Form?
The LIC 602A is the Physician's Report for Residential Care Facilities for the Elderly (RCFE), published by the California Department of Social Services (CDSS) Community Care Licensing Division. “RCFE” is the state's licensing term for assisted living, memory care, and board and care homes, which is why the form applies to all three.
In plain terms, the LIC 602A is a medical snapshot. A licensed physician reviews your loved one's health and documents their diagnoses, medications, mobility, cognitive status, and the level of help they need with daily activities. The community uses that snapshot to answer one essential question: can we safely meet this person's needs?
The form is often called the “602 form,” “602A,” or simply “the physician's report.” They all refer to the same document.
Why California Requires the LIC 602A
Assisted living communities in California are licensed as non-medical facilities. That means they provide housing, meals, supervision, and help with daily living, but they are not hospitals or skilled nursing facilities. State regulations (Title 22 of the California Code of Regulations) require every licensed RCFE to obtain a physician's medical assessment before accepting a new resident. The LIC 602A is the standard form that satisfies this requirement.
The rule exists to protect residents. It ensures that:
The community can meet the person's needs
A resident who requires round-the-clock nursing care, for example, may need a different setting
Staff know what to watch for
Diagnoses, allergies, and behavioral considerations are documented before day one
Medications are managed correctly
The community knows what the resident takes and whether they can self-administer
Other residents and staff are protected
The form confirms the person does not have active tuberculosis or another communicable disease
Emergency planning is accurate
Mobility status determines evacuation plans and, in some cases, which rooms a resident may occupy
What the LIC 602A Covers
The form is several pages long and is divided into sections. Here is what your loved one's doctor will be asked to document:
In plain terms, the LIC 602A is a medical snapshot. A licensed physician reviews your loved one's health and documents their diagnoses, medications, mobility, cognitive status, and the level of help they need with daily activities. The community uses that snapshot to answer one essential question: can we safely meet this person's needs?
The form is often called the “602 form,” “602A,” or simply “the physician's report.” They all refer to the same document.
Resident information
Name, date of birth, and the community the person is moving into (usually completed by the family)
Tuberculosis (TB) screening
Date the test was given and read, type of test, result, and chest X-ray findings if the test was positive
Primary and secondary diagnoses
The medical conditions the community needs to be aware of
Contagious or infectious diseases
Confirmation that the person is free of any condition that would put others at risk
Allergies
Medications, foods, and other known allergies
Physical health status
Vision, hearing, speech, mobility, continence, and the ability to walk or transfer independently
Mental and cognitive status
Memory, orientation, confusion, and any behavioral considerations such as wandering or aggression
Self-care and daily living
How much help the person needs with bathing, dressing, grooming, eating, and toileting
Medication management
A list of current medications and whether the person can safely take them without assistance
Ambulatory status
Whether the person is ambulatory, non-ambulatory, or bedridden, as defined by California law
Physician's signature
The doctor's name, address, phone number, license information, and signature with date
Why Your Doctor or Primary Care Physician Must Complete It
Families sometimes ask whether they can fill out the LIC 602A themselves, or whether the community can complete it. The answer is no, and the reason matters.
It is a medical assessment, not a questionnaire.
The state requires a licensed physician to evaluate the person's condition and sign the report. A community cannot accept a resident based on a family's description of their health, no matter how accurate.
The physician's signature is what makes it valid.
Licensing regulations are written so that a medical professional, not the community, determines whether the person is appropriate for a non-medical setting. The signature carries legal weight and is what state inspectors look for in the resident's file.
The primary care physician knows your loved one best.
The PCP has the medical history, current medication list, and recent lab work at hand. That makes the report faster to complete and more accurate than one from a doctor who is meeting the patient for the first time.
The TB screening must be ordered by a clinician.
A TB skin test or blood test has to be given, read, and interpreted by a medical provider, and the results must be documented on the form.
It protects your family, too.
An accurate report means the community is properly prepared, staff have the information they need, and there are no surprises about the level of care after move-in.
Who Can Sign the LIC 602A?
Historically, only a physician (MD or DO) could sign the form. Newer versions of the LIC 602A allow a nurse practitioner or physician assistant to complete it in many situations. Because policies vary and the form is periodically revised, always confirm with the community, or with your Golden Pathways advisor, who they will accept as the signing provider.
How to Get the LIC 602A Completed Without Delaying the Move
The LIC 602A is the single most common cause of a postponed move-in date. These steps keep the process on track:
Start early.
Request the form as soon as you begin touring communities. Physician's offices can take one to three weeks to return it.
Get the current version
Download the latest form from the CDSS website or ask the community for a copy. Outdated versions are sometimes rejected.
Complete the resident section before you go
Fill in your loved one's name, date of birth, and the community name so the doctor's office only has to handle the clinical sections.
Schedule an appointment specifically for the form
A dedicated visit is faster than asking the office to complete it between patients. Ask whether the TB test can be given at the same visit.
Plan for the TB test timing
A TB skin test must be read 48 to 72 hours after it is placed, which means a second visit. A TB blood test avoids the return trip but may take several days for results.
Review the completed form before submitting it
Check that every section is filled in, the TB results are recorded, and the signature and date are present. Blank fields are the most common reason communities send the form back.
Send it to the community and keep a copy
Deliver the original to the admission representative and keep a copy for your records.
Mobile Physician Services
If your loved one is homebound, in the hospital, or cannot get to a doctor's office easily, several mobile physician services in Los Angeles County will come to the home or hospital to complete the LIC 602A and TB screening. Your Golden Pathways advisor can point you toward these options.
How Long Is the LIC 602A Valid?
California regulations require that the medical assessment and TB test be completed within one year before the admission date. In practice, most communities prefer a report that is no more than 30 to 90 days old so it reflects the person's current condition. After move-in, the community may ask for an updated report if your loved one's health changes significantly, after a hospitalization, or as part of its ongoing reassessment process. Confirm the specific timing policy with each community you are considering.
Why Contact Golden Pathways for Help With the LIC 602A
Paperwork should never be the reason a family misses a move-in date. Golden Pathways guides families in Los Angeles, Orange, Ventura, San Bernardino, and Riverside counties through every step of the placement process, including the LIC 602A, at no cost to the family.
Here is why families across Southern California call us first:
We explain the form in plain language.
We walk you through each section so you know what the doctor will be asked and why.
We help you get it done.
We tell you what to request from the physician's office, how to handle the TB test, and what to do if your loved one cannot travel to an appointment.
We check it before the community does.
We review the completed form for missing fields, dates, and signatures so it is accepted the first time.
We coordinate with the community.
We confirm what the admission team requires, including which version of the form and which signing providers they accept.
We answer every question.
Not sure whether a hospital discharge summary counts? Wondering if a report from a specialist will work? Call us. There is no such thing as a silly question when it comes to your family.
Our service is free.
Golden Pathways is paid by the senior care communities we partner with, so families never pay for our guidance.
Have a question about the LIC 602A or ready to get started?
We are with you every step of the way.
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Disclaimer
The information on this page is provided for general informational purposes only. It is not intended to be, and should not be relied upon as, medical, legal, or financial advice. Form requirements, regulations, and community policies change over time and may vary by facility. Please consult a licensed physician, attorney, or other qualified professional regarding your specific situation, refer to the California Department of Social Services for the current version of the LIC 602A form and applicable regulations, and confirm all requirements directly with the community your loved one will be moving into. Golden Pathways is a senior placement and referral service and does not provide medical or legal services.