Fill Out Your Lic 9163 Facility Number Form

What is the Lic 9163 Facility Number form?

The Lic 9163 Facility Number form is a document used by applicants seeking work or volunteer roles in various licensed facilities in California. It is primarily utilized for the live scan fingerprinting process, which is a requirement for background checks in order to ensure safety and compliance in community care settings. This form captures essential personal information and is crucial for obtaining a facility number and facilitating the criminal history check.

Who needs to fill out the Lic 9163 form?

This form needs to be filled out by individuals applying for positions that require a background check in community care licensing. This includes employees, volunteers, and applicants for positions in various types of facilities such as adult residential facilities, child care centers, and home care organizations. Essentially, anyone planning to work with vulnerable populations in these environments must complete the form.

How do I complete the Lic 9163 form?

To complete the Lic 9163 form, begin by printing your full name and providing any additional names you may have. Fill in your driver's license number or another form of ID, date of birth, sex, height, weight, eye color, and hair color. Next, enter the facility number associated with the agency where you will be working. Make sure to select the type of authorized applicant you are, according to the list provided. It's also essential to provide your home address and social security number, although the latter is optional.

What should I do if my fingerprints are rejected?

If your fingerprints are rejected, you will need to resubmit them. For this, you must enter the original Applicant Tracking Information (ATI) number provided with the rejection notice on the Lic 9163 form. This ensures that you will not be charged an additional fee for the second submission, allowing the process to move forward efficiently.

Why is my Social Security Number (SSN) needed?

Your SSN is used by the California Department of Justice as a unique identifier during the background check process. Although providing your SSN is voluntary, failure to include it may delay the processing of your background check and, consequently, your eligibility to work in a licensed facility. This requirement aligns with compliance regulations aimed at safeguarding vulnerable populations.

What happens after I submit the Lic 9163 form?

After submitting the Lic 9163 form, the information collected will be used to initiate a background check through live scan fingerprinting. The Department of Social Services will review your criminal history. If there are no issues, you will receive a facility number, allowing you to work, volunteer, or be present in a licensed facility. If your background check reveals any problematic information, appropriate actions will be taken as required by law.

Where can I get assistance with the Lic 9163 form?

If you have questions or need assistance while filling out the Lic 9163 form, you can contact your local licensing regional office. They will provide guidance and resources to help you understand the requirements and ensure that your application is completed accurately.

Is there a deadline for submitting the Lic 9163 form?

While there is no strict deadline outlined in the instructions, it is advisable to submit the Lic 9163 form as soon as possible. Processing times for background checks can vary, and delays in submission may affect your ability to secure employment or volunteering opportunities in a timely manner. To avoid delays, ensure that you complete the form fully and accurately before submitting.

Filling out the Lic 9163 Facility Number form correctly is crucial for the success of your application. However, many make common mistakes that can cause unnecessary delays or complications. Understanding these pitfalls can save you time and help ensure your application is processed smoothly.

One prevalent mistake is neglecting to complete the Authorized Applicant Type field accurately. It's essential to select the right category from the provided list based on where you will be working. If you fail to choose a specific facility type or mistakenly select more than one, it can lead to confusion, requiring you to resubmit the form. Always ensure that you note only the one facility type that best represents your daily responsibilities.

Another frequent error involves the Facility/Organization Number. Applicants sometimes forget to include this vital piece of information or enter an incorrect number. This oversight can significantly delay the processing of your application, as the Department of Social Services uses this number to identify your facility. Double-checking this entry before submitting can help avoid setbacks.

The Contact Information section is often filled out incorrectly. Some applicants neglect to provide a contact name, which is mandatory for all school submissions. Additionally, failing to include an accurate telephone number can hamper communication with the Department, potentially leading to delays. Make sure your contact details are clearly printed and complete.

Many people also struggle with the Applicant Information section. Errors such as misspellings in your name, incorrect date of birth, or wrong social security numbers can create major issues. These inaccuracies can raise questions during the background check process. Therefore, take your time when filling out this section, ensuring every detail is correct.

When it comes to the Live Scan Transaction Completed By section, some applicants forget to sign or date this part before submission. This oversight can cause the form to be considered incomplete. Not only does this delay processing, but it may also require you to travel back to the Live Scan operator to rectify it. Always remember to check for the signature and date before you leave the facility.

Lastly, applicants frequently overlook providing identifying numbers in the MISC No fields. These numbers, such as your agency billing number or driver’s license number (if applicable), are important for tracking and verifying your application. Failing to provide this information might result in challenges in processing your form. By being diligent and thorough in this section, you can help facilitate a smoother review process.

The LIC 9163 Facility Number form is an essential document used for criminal background checks in various licensed facilities in California. Yet, it is often accompanied by several other forms that help streamline the application process and ensure compliance with state regulations. Below are some commonly used documents in conjunction with the LIC 9163.

• Live Scan Notice: This document provides information on Live Scan fingerprinting procedures, including locations, fees, and identification requirements. It serves as a guide for applicants to prepare for their fingerprint submissions.
• Criminal Background Check Request Form: This form is utilized to formally request a review of an applicant's criminal history. It is crucial for ensuring that all necessary background information is collected and processed along with the Live Scan results.
• Specify Services Request Form: Used to clarify the specific services or roles that the applicant will perform at the facility. This form helps agencies assess the nature of the work and aligns it with the required background checks.
• Client Consent Form: This form is a written agreement where the applicant consents to the background check and the release of any pertinent information. It ensures that applicants understand their rights and the nature of the background investigation.
• Employment Application: Often required for prospective employees, this application outlines the individual's work history, qualifications, and personal information. It serves as a preliminary assessment of the candidate before the background check is completed.
• Verification of Employment Form: This document is used to confirm the applicant's previous employment and may be required by some facilities during the hiring process. It provides additional context to assist in evaluating the applicant's background.

Each of these documents works together with the LIC 9163 form to facilitate the hiring process while ensuring compliance with state regulations. It's important for applicants to be prepared with these forms to navigate the certification and employment process efficiently.

The Lic 9163 Facility Number form serves a vital role in the context of background checks for various applicants in California’s community care systems. Several other documents share similarities with the Lic 9163 form, primarily in their purpose or process. Below is a list of ten such documents and how they relate to the Lic 9163 form.

• Request for Live Scan Service - DOJ Form: This document is also used to request fingerprinting services through Live Scan. Both forms require similar applicant information and facilitate the collection of fingerprints for background checks.
• Applicant Fingerprint Card (FD-258): Similar to the Lic 9163, this is a fingerprint card used for submitting fingerprints to the FBI. The focus of both documents centers on identifying applicants through fingerprinting.
• Criminal History Background Check Application: Like the Lic 9163, this document is aimed at initiating a criminal record check. Both documents require personal details for processing background investigations.
• Department of Social Services (DSS) Child Care Provider Application: This application is necessary for individuals wanting to work in child care facilities. It also requires comprehensive applicant information similar to that on the Lic 9163.
• Health Care Employment Application: Used by health facilities to gather essential information about an applicant, this document also pertains to background verification like the Lic 9163.
• Volunteer Fingerprinting Request Form: This form is used by organizations requesting background checks for volunteers. It bears a resemblance to the Lic 9163 due to its purpose of ensuring the safety of vulnerable populations.
• IVF and Surrogacy screening forms: For individuals involved in assisted reproductive technology, these forms collect personal information to vet applicants before proceeding with sensitive processes, akin to the Lic 9163.
• State Licensing Application for Preschools: Similar to the Lic 9163, this form requires applicant details and includes a criminal background check component as part of maintaining safety in preschool environments.
• Foster Care Application Form: This document collects detailed information from prospective foster parents, ensuring rigorous background checks, paralleling the information collected in the Lic 9163.
• Home Care Aide Registry Application: Like the Lic 9163, this application gathers necessary personal details to facilitate background checks for home care workers, aligning its purpose with ensuring the safety of clients.

In summary, these documents share the goal of protecting individuals by ensuring comprehensive background checks are completed for applicants in various roles across health and social services sectors. Each serves to affirm the integrity and safety of the environments in which these applicants would work.

When filling out the Lic 9163 Facility Number form, there are important dos and don’ts to consider. Adhering to these guidelines can streamline the process and enhance accuracy.

• Do ensure that all personal information is accurate and legible. Double-check your details to avoid any delays.
• Do select the correct working title that reflects your current role. This is crucial for proper categorization.
• Do use the authorized applicant type from the specified list. Be precise to prevent complications in your application.
• Do provide a permanent address and contact number. This information is essential for communication regarding your application status.
• Do keep a copy of the completed form for your records. Documentation is beneficial for future reference.

• Don’t leave any required fields blank. Incomplete forms can result in processing delays.
• Don’t select multiple facility types. Choose the one that most closely aligns with your daily responsibilities.
• Don’t forget to enter your Social Security Number if you choose to provide it. Omitting this could delay your background check.
• Don’t rush through the form. Take your time to carefully read each section to ensure comprehension.
• Don’t overlook the contact information for the agency. Having it at hand can aid in addressing any questions or issues that arise.

Here are five misconceptions about the Lic 9163 Facility Number form:

• Misconception 1: Anyone can submit this form without proper authorization.

This form is specifically for authorized applicants, which include employees, volunteers, and license applicants of licensed facilities. Only those connected to these roles should complete it.

• Misconception 2: The facility number is optional.

In fact, the facility number is crucial. It identifies the specific facility associated with your application and ensures that your information is correctly linked to the appropriate agency.

• Misconception 3: Providing a Social Security Number is mandatory.

While it's suggested for identification purposes, providing a Social Security Number is voluntary. Not supplying this information might delay processing, but it won’t disqualify you from submission.

• Misconception 4: Only one working title can be checked.

You may identify with multiple roles within a facility. However, you must select the role that you are primarily associated with on a day-to-day basis.

• Misconception 5: Submission guarantees approval for clearance.

Submitting the form does not automatically mean you will receive clearance. Approval is contingent upon a successful criminal background check, which may take time to process.

• Understanding the Purpose: The LIC 9163 Facility Number form is essential for individuals seeking employment in licensed facilities, allowing for the necessary background checks to ensure safety and compliance.

• Accurate Information is Crucial: When filling out the form, it is vital to provide accurate personal information, including your full name, date of birth, and identification details, to avoid processing delays.

• Selecting the Right Category: Be sure to check the appropriate box under the Working Title section, indicating your role, whether as an employee, volunteer, or home care aide.

• Authorized Applicant Type: Select the facility type where you’ll be working. Only one category should be chosen that best reflects your daily responsibilities.

• Facility Number Requirement: Enter the facility or agency number accurately to link your application to the correct organization.

• Live Scan Process: You must take two copies of the completed form to the Live Scan site when getting fingerprinted. The Live Scan operator will complete part of the form.

• Keep a Copy: Retaining your copy of the form is essential for your records. This provides proof of your fingerprint submission and can aid in tracking your application.

• Be Aware of Privacy Rights: Familiarize yourself with privacy statements regarding your personal information. You have the right to access records related to your criminal background check.