Loading
Form preview picture

Get Lic 622 1999-2024

Medication records on each client/resident shall be maintained for at least one year. NAME LAST MEDICATION NAME LIC 622 3/99 CONFIDENTIAL FIRST STRENGTH/ QUANTITY MIDDLE CONTROL/CUSTODY EXPIRATION DATE ADMISSION DATE FILLED STARTED ATTENDING PHYSICIAN PRESCRIBING PHYSICIAN ADMINISTRATOR PRESCRIPTION NO. STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING CENTRALLY STORED MEDICATION AND DESTRUCTION RECORD FACILITY NAME INSTRUCTIONS Centrally stored medications shall be kept in a safe and locked place that is not accessible to any person s except authorized individuals. OF NUMBER REFILLS NAME OF PHARMACY II. MEDICATION DESTRUCTION RECORD Designated Representative and witnessed by one other adult who is not a client/resident. All facilities except Residential Care Facilities for the Elderly RCFEs shall retain destruction records for at least one year. RCFEs shall retain records for at least three years. DATE FILLED PRESCRIPTION DISPOSAL NAME OF PHARMACY SIGNATURE OF ADMINISTRATOR OR DESIGNATED REPRESENTATIVE SIGNATURE OF WITNESS ADULT NON-CLIENT. OF NUMBER REFILLS NAME OF PHARMACY II. MEDICATION DESTRUCTION RECORD Designated Representative and witnessed by one other adult who is not a client/resident. All facilities except Residential Care Facilities for the Elderly RCFEs shall retain destruction records for at least one year. All facilities except Residential Care Facilities for the Elderly RCFEs shall retain destruction records for at least one year. RCFEs shall retain records for at least three years. DATE FILLED PRESCRIPTION DISPOSAL NAME OF PHARMACY SIGNATURE OF ADMINISTRATOR OR DESIGNATED REPRESENTATIVE SIGNATURE OF WITNESS ADULT NON-CLIENT. OF NUMBER REFILLS NAME OF PHARMACY II. MEDICATION DESTRUCTION RECORD Designated Representative and witnessed by one other adult who is not a client/resident. All facilities except Residential Care Facilities for the Elderly RCFEs shall retain destruction records for at least one year. RCFEs shall retain records for at least three years. DATE FILLED PRESCRIPTION DISPOSAL NAME OF PHARMACY SIGNATURE OF ADMINISTRATOR OR DESIGNATED REPRESENTATIVE SIGNATURE OF WITNESS ADULT NON-CLIENT. .

How It Works

lic 622 9 19 rating
4.82Satisfied
45 votes

Tips on how to fill out, edit and sign Centrally stored medication lic 622 online

How to fill out and sign Centrally stored medication record online?

Get your online template and fill it in using progressive features. Enjoy smart fillable fields and interactivity. Follow the simple instructions below:

Feel all the key benefits of submitting and completing legal documents on the internet. Using our service submitting CA LIC 622 will take a matter of minutes. We make that achievable by offering you access to our full-fledged editor capable of transforming/correcting a document?s original text, adding special boxes, and putting your signature on.

Fill out CA LIC 622 within a couple of moments by simply following the instructions listed below:

  1. Find the template you want from our collection of legal forms.
  2. Click the Get form button to open the document and move to editing.
  3. Complete all the necessary fields (these are yellowish).
  4. The Signature Wizard will enable you to put your electronic signature as soon as you have finished imputing data.
  5. Insert the date.
  6. Double-check the entire document to ensure you have filled in all the data and no changes are required.
  7. Hit Done and download the ecompleted form to your device.

Send your CA LIC 622 in an electronic form as soon as you finish completing it. Your data is well-protected, because we keep to the latest security criteria. Join numerous satisfied users who are already submitting legal forms from their houses.

Get form

Experience a faster way to fill out and sign forms on the web. Access the most extensive library of templates available.

Video instructions and help with filling out and completing lic 622b

Go through the latest techniques in digital administration. Fill out Form within minutes with a help of our straightforward step-by-step video guidelines.

Lic622b FAQ

Get This Form Now!

Use professional pre-built templates to fill in and sign documents online faster. Get access to thousands of forms.

Keywords relevant to lic 622 centrally stored

  • lic 622 pdf
  • lic 622a
  • lic 622 medication
  • lic 622a form
  • stored medication record
  • lic centrally stored medication
  • lic medication administration record
  • lic medication form
  • medication destruction log
  • medication destruction log template
  • medication destruction record
  • medication destruction record form
  • medication disposal form
  • medication disposal form template
  • state of calofornia lic 622
If you believe that this page should be taken down, please follow our DMCA take down processhere.
Ensure the security of your data and transactions

USLegal fulfills industry-leading security and compliance standards.

  • 
                            VeriSign logo picture

    VeriSign secured

    #1 Internet-trusted security seal. Ensures that a website is free of malware attacks.

  • Accredited Business

    Guarantees that a business meets BBB accreditation standards in the US and Canada.

  • 
                            TopTenReviews logo picture

    TopTen Reviews

    Highest customer reviews on one of the most highly-trusted product review platforms.