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California's Form 602a for Residential Care Facilities

By Michaela KitchenFebruary 17, 2022
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There are many factors to consider when preparing to move your senior loved one into a care facility. From getting all the legal documents in place to financial planning, each step is important to ensure your loved one has a smooth transition to senior living.

For families in California who want their loved ones to move into a licensed residential care facility for the elderly, there’s an extra step. A physician must submit a report describing the resident’s care needs in order to ensure that the facility can meet those needs. Most commonly, physicians provide this information in a Form LIC 602a, often referred to as a Form 602a.

Read on to learn more about residential care facilities for the elderly, the form itself, and how to help your family avoid potential problems that could delay the move-in process.

What is a residential care facility for the elderly?

A residential care facility for the elderly, or an RCFE, is a California-licensed facility that provides seniors with daily living care, memory care, and supervision depending on the specific facility’s licensed qualifications. These facilities and their regulations are specific to California — however, the facilities are similar to assisted living facilities in other states.

In California, each facility’s license determines the level of care that it’s allowed to provide. Each facility must have admissions requirements that ensure the residents’ needs can be properly addressed.

What is California’s Form 602a?

Form 602a is the California state physician’s report that informs a licensed residential care facility for the elderly about a potential resident’s needs for care, medication, assistance, and more.

By state regulation, residential care facilities for the elderly in California are required to determine that their residents meet the facility’s specific admission criteria and that the facility can provide proper care.

Using Form 602a is one way to ensure that the facility has all the information it needs before the senior can move into the facility.

The standard California Department of Social Services form includes information about the senior’s current medical and physical status and their medical history.

Families can find the form on the California Department of Social Services website. A Place for Mom advisors also have the form handy for families who want to move a loved one into a California residential care facility for the elderly.

The physician’s report requires the following:

  • A patient history
  • A patient physical examination
  • A tuberculosis (TB) skin test or a chest X-ray to rule out active pulmonary tuberculosis

Important note: Information from the form will not only need to be collected prior to admission to an RCFE but also when the Department of Social Services requires an updated assessment, or annually for residents with dementia.

Who completes the Form 602a?

A senior’s primary physician needs to complete this form. If your loved one is in a skilled nursing community or hospital, the attending physician there may also complete it. It’s preferable to have your loved ones’ primary care physician complete the form, though, because they have a more in-depth knowledge of your loved one’s medical history.

Also, be aware that it can take some time for a physician to return the form, so it’s better to deliver the form to a physician well before it will be needed.

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Setting up the doctor’s appointment

Follow the normal process for making an appointment with your senior loved one’s medical provider. However, when scheduling the appointment, it’s important to mention that the purpose of the appointment is to complete a physician’s report, Form 602a — it can take extra time, and the office will need to be prepared.

It’s also important to note that, depending on the type of insurance or medical provider your loved one has, they may be required to go through the insurance’s member services first.

Important details on the form

There are several items on the form that need specific, careful attention. One example is specifying the diagnostic difference between mild cognitive impairment (MCI) and dementia, as these diagnoses result in different care needs.

Another specific area to focus on is whether the physician thinks the senior loved one can leave a community with or without assistance.

It’s important to note that all boxes and items must be filled out to ensure there are no questions about care. If a mistake is made, it should not just be crossed out and corrected on the form. Mistakes require adding a new page that explains the change, and the physician must sign next to the correction.

Caregivers’ role in completing Form 602a

Families should be seniors’ biggest advocates to get the forms filled out accurately and in a timely manner. A family member could contact the physician’s office regularly to check on the form’s status. It’s always a good idea to respectfully and clearly communicate the importance of quickly returning the form.

The form is an important part of helping the family make a well-informed choice when choosing a new home with and for their loved one.


California Assisted Living Association. (n.d.). RCFEs in California.

Policy team of California Assisted Living Association. (2022, February 09). Electronic communication. [Email Interview].

Michaela Kitchen

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