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In the realm of health and human services within the State of California, the LIC 309 form plays a crucial role for corporations, limited liability companies, public agencies, partnerships, and other associations involved in managing community care facilities. Designed to ensure that the California Department of Social Services' Community Care Licensing Division is kept up to date, this form mandates the reporting of any changes concerning partners, officers, or alterations in the organization's structure as stipulated by the California Code of Regulations. Its comprehensive layout demands detailed information, including the organization's name as recorded with the Secretary of State, chief executive officers, incorporation details, and a bevy of other critical data points such as a list of individuals holding a significant interest in the entity, directors and officers details, and for those out of state, a California representative. Additionally, it requires the attachment of fundamental organizational documents like Articles of Incorporation, By-Laws, or Operating Agreements along with any amendments, emphasizing the form's role in ensuring transparency and accountability. For public agencies, the form slightly shifts focus, requiring specifics about the type of agency, service details, and geographic area served, underlining the form's adaptability across various organizational structures aiming to operate care facilities within California.

Preview - Lic 309 Form

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

ADMINISTRATIVE ORGANIZATION

(This side is for corporations and limited liability companies only. See reverse for public agencies, partnerships, and other associations.)

INSTRUCTIONS: This form must be updated and submitted to the Licensing Agency each time there is a change in partners, officers or changes in the corporation or limited liability company as provided in the Callifornia Code of Regulations Title 22, Section 80034(a)(2), or 87235(a)(5), or 101185(a)(2).

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES

COMMUNITY CARE LICENSING DIVISION

DATE

FACILITY NAME

FACILITY ADDRESS

FACILITY NUMBER

I. CORPORATION/LIMITED LIABILITY COMPANY (LLC)

1. Name (as filed with Secretary of State)

2.Chief Executive Officer

3.Incorporation/Registration Date

4.Place of Incorporation/Registration

Corporation/Limited Liability Company Number

5.Please attach (1) A copy of Articles of Incorporation or organization and any amendments (2) A copy of By-Laws or Operating Agreement and any amendments (3) A copy of Resolution authorizing the filing of this application (for Corporations only).

6.Principal office of business:

Address

City

Zip Code

County

Telephone No.

Contact Person:

Title:

 

Telephone No.:

 

7. Out of state or foreign applicants complete the following:

 

 

 

a. Name of California Representative

 

Address

Zip Code

Telephone No.

b.Please attach a copy of a foreign corporation’s or foreign LLC’s registration to do business in California.

8.Names and addresses of all persons who own ten percent (10%) or more interest in corporation or LLC. Attach sheet for additional space.

9.Directors (Corporation)/Managers and Managing Members (LLC)

a.Number of Directors/Managers & Managing Members

b.Term of Office (if applicable)

c.Frequency of Meetings (if applicable)

d.Method of Selection (corporations only)

10.Officers: (For LLCs without officers, skip this section and go to Section II)

Office

Name

Principal Business Address & City & Zip Code

(other than facility address)

 

 

Telephone No.

Term Expires

President

Vice-President

Secretary

Treasurer

LIC 309 (6/01) (PUBLIC)

11.List all Directors (Corporations)/Managers and Managing Members (LLC)

Name

Mailing Address & City & Zip Code

Telephone No.

Term Expires

(Attach Sheet for additional space)

II.PUBLIC AGENCY

1. Check type of public agency:

Federal

State

County

City

Other, specify below

2.Agency providing services:

Name: _______________________________________________ Address: ___________________________________________________________

CITY/STATE

Mailing Address: _____________________________________________________________________________________________________________

 

CITY/STATE/ZIP CODE

Contact Person: __________________________________

Title: ___________________________________ Phone No.:_______________________

3.District or Area to be served: (attach map if necessary) Specify geographic area:

4.Attach copy of Resolution or legal document authorizing this application.

III.PARTNERSHIPS

Attach a copy of partnership agreement (attach additional sheet if necessary)

1st Partner

General

Name

 

 

 

 

TELEPHONE NUMBER

 

Limited

Principal Business Address

 

 

 

 

CITY/STATE

2nd Partner

General

Name

 

 

 

 

TELEPHONE NUMBER

 

Limited

Principal Business Address

 

 

 

 

CITY/STATE

3rd Partner

General

Name

 

 

 

 

TELEPHONE NUMBER

 

Limited

Principal Business Address

 

 

 

 

CITY/STATE

4th Partner

General

Name

 

 

 

 

TELEPHONE NUMBER

 

Limited

Principal Business Address

 

 

 

 

CITY/STATE

Contact Person: _______________________________ Title: __________________________________ Telephone No.: ___________________

IV. OTHER ASSOCIATIONS

Other associations must also provide a similar list of persons legally responsible for the organization, contact person, appropriate legal documents which set forth legal responsibility of the organization and accountability for operating the facility.

Form Data

Fact Name Description
Form Designation LIC 309
Purpose Updates for corporation or limited liability company changes
Governing Law(s) California Code of Regulations Title 22, Section 80034(a)(2), 87235(a)(5), or 101185(a)(2)
Agency California Department of Social Services Community Care Licensing Division
Applicability Corporations and limited liability companies
Requirements Attachment of Articles of Incorporation, By-Laws, and, for corporations, a Resolution
Foreign Entity Provision Requirement for foreign entities to attach registration to do business in California
Ownership Disclosure Disclosure of individuals owning 10% or more interest

Instructions on Utilizing Lic 309

Filling out the LIC 309 form is an important step for corporations or limited liability companies (LLCs) involved in the management or ownership of facilities regulated by the California Department of Social Services Community Care Licensing Division. The form serves as a key document for keeping the licensing agency informed about the entity's current operational structure, including any changes in partners, officers, or ownership stakes. Failure to submit an updated form when changes occur can result in regulatory compliance issues. Therefore, ensuring accurate and prompt completion of this form is crucial for maintaining good standing with the licensing authority.

To complete the LIC 309 form, follow these steps carefully:

  1. At the top of the form, provide the date, name of the facility, facility address, and facility number as registered.
  2. In Section I. CORPORATION/LIMITED LIABILITY COMPANY (LLC), enter the name of the entity as filed with the Secretary of State.
  3. Identify the chief executive officer and add their information in the designated area.
  4. Provide the incorporation/registration date, the place of incorporation/registration, and the corporation/limited liability company number.
  5. Attach the required documents:
    • A copy of the Articles of Incorporation or Organization and any amendments.
    • A copy of the By-Laws or Operating Agreement and any amendments.
    • A copy of the Resolution authorizing the filing of this application (for Corporations only).
  6. Provide the principal office of business address, city, zip code, county, telephone number, and the contact person’s title and telephone number.
  7. If applicable, complete the section for out of state or foreign applicants by providing the name of the California representative, their address, and a copy of the foreign corporation's or LLC's registration to do business in California.
  8. List the names and addresses of all persons who own ten percent (10%) or more interest in the corporation or LLC. If additional space is needed, attach a separate sheet.
  9. Provide details regarding the directors (for corporations) or managers and managing members (for LLCs), including the number, term of office, frequency of meetings, and method of selection (for corporations only).
  10. For corporations with officers, list the officers (President, Vice-President, Secretary, Treasurer), including their names, principal business addresses (other than facility address), telephone numbers, and when their terms expire.
  11. List all directors/managers and managing members, including their names, mailing addresses, telephone numbers, and when their terms expire. Attach an extra sheet if necessary.

Ensure that all information provided is accurate and up-to-date. After completing the form, double-check all entries and attach any required additional documents. Submit the completed form and attachments to the California Department of Social Services Community Care Licensing Division as directed. Timely submission is essential to avoid potential delays or issues with your facility's licensing status.

Obtain Answers on Lic 309

FAQ: Understanding the LIC 309 Form

  1. What is the purpose of the LIC 309 form?

    The LIC 309 form is a document required by the State of California Health and Human Services Agency, specifically for corporations and limited liability companies (LLCs) that are involved in community care licensing. Its main purpose is to ensure that any changes in the partnership, officers, or structural changes within the corporation or LLC are officially updated and communicated to the Licensing Agency in accordance with specified sections of the California Code of Regulations. This helps maintain transparency and up-to-date records for entities involved in providing community care services.

  2. What are the key sections of the LIC 309 form?

    • Corporation/Limited Liability Company (LLC) Information: This section collects details about the entity's name, chief executive officer, incorporation/registration date and place, entity number, principal office address, and contact information.

    • Documentation Attachments: Entities are required to attach copies of their Articles of Incorporation or Organization, By-Laws or Operating Agreement (and any amendments), and, for corporations, a copy of the resolution authorizing the filing of this application.

    • Ownership and Management Information: Details regarding individuals who own a significant interest in the entity (10% or more), as well as information on directors, managers, or managing members, need to be provided.

    • List of Officers (for LLCs that have officers): This includes the names, business addresses (other than the facility address), and term expirations for each officer position.

    • Additionally, the form has sections for public agencies, partnerships, and other associations to fill out pertaining to their specific organizational structures.

  3. When should the LIC 309 form be submitted?

    The form must be submitted to the California Department of Social Services Community Care Licensing Division each time there is a change in partners, officers, or the corporation/LLC as provided in the specified sections of the California Code of Regulations. This ensures that the licensing records are always current and reflect the actual leadership and operational structure of the entity.

  4. What documentation needs to be attached with the LIC 309 form?

    Entities are required to attach the following documents:

    • A copy of the Articles of Incorporation or organization and any amendments.
    • A copy of the By-Laws or Operating Agreement and any amendments.
    • For corporations only, a copy of the Resolution authorizing the filing of this application.
    • For out-of-state or foreign applicants, a copy of the registration to do business in California.

    These attachments help verify the legal and operational framework of the entity applying for or updating their community care license.

  5. How do foreign corporations or LLCs comply with the LIC 309 requirements?

    Foreign corporations or LLCs must complete the section dedicated to out-of-state or foreign applicants, providing the name and address of a California representative. Additionally, they must attach a copy of their foreign corporation’s or LLC’s registration to do business in California. This ensures that even entities not originally from California, but intending to operate within the state, are properly documented and regulated in accordance with California's community care licensing requirements.

Common mistakes

When filling out the LIC 309 form, it's crucial to be accurate and thorough. Despite the clear instructions provided, several common mistakes are made:

  1. Not updating the form promptly when there are changes in partners, officers, or the structure of the corporation or limited liability company, as required by regulations.
  2. Failing to provide the name of the corporation or LLC exactly as it is filed with the Secretary of State. This mistake can lead to a mismatch in official records, causing delays.
  3. Omitting the attachment of required documents such as the Articles of Incorporation, By-Laws, Operating Agreement, and any amendments to these documents.
  4. Incorrectly listing the names and addresses of individuals who own ten percent (10%) or more of the interest in the corporation or LLC, or failing to attach additional sheets when more space is needed.
  5. Overlooking the completion of section 7 for out-of-state or foreign applicants, which requires the name of a California representative and the attachment of a registration to do business in California.
  6. Not correctly distinguishing between directors (for corporations) and managers or managing members (for LLCs), including their terms of office, frequency of meetings, and method of selection.
  7. For public agencies, failing to attach a copy of the resolution or legal document authorizing the application, which is crucial for validating the application.

Attention to detail is key when completing the LIC 309 form to ensure compliance with California regulations and to facilitate smooth processing.

Documents used along the form

When applying for approval or updating records with the Lic 309 form, applicants must often gather additional documents to ensure a comprehensive submission. This suite of forms and documents supports the processing of the Lic 309 form by providing detailed information on the entity's structure, legal standing, and operational guidelines. Such documentation is vital for the transparent and efficient evaluation of an application by the California Department of Social Services Community Care Licensing Division.

  • Articles of Incorporation or Organization: This document officially registers the corporation or LLC, establishing its legal existence. It details the entity’s purpose, place of business, and the distribution of shares.
  • By-Laws or Operating Agreement: Outlining the rules for the governance and operation of the entity, By-Laws (for corporations) or an Operating Agreement (for LLCs) detail the duties of officers, voting rights, and meeting protocols.
  • Resolution Authorizing Application (Corporations only): A formal declaration by the board of directors that approves the submission of the Lic 309 application, underscoring the entity's commitment to comply with regulatory requirements.
  • Registration to Do Business in California (For out-of-state or foreign entities): This document is required for entities not originally established in California but intending to operate within the state, illustrating compliance with California business laws.
  • Partnership Agreement: Essential for entities structured as partnerships, this agreement specifies the terms of partnership, including the distribution of profits and losses, decision-making processes, and partner responsibilities.
  • Legal Document Establishing Public Agency Authority: For public agencies, a statute, charter, or other legal documents are needed to demonstrate the agency’s legitimate authority to operate and manage a facility.
  • Map of Service Area: Particularly relevant for public agencies, a detailed map indicates the geographic boundaries within which services will be delivered, helping to clarify the scope of operations.

Each document plays a crucial role in the application process, collectively serving to paint a full picture of the organization applying through the Lic 309 form. These documents ensure that all legal, operational, and governance aspects are transparent, allowing for a thorough review by the licensing agency. Ensuring that all relevant documents are accurately completed and submitted alongside the Lic 309 form can significantly streamline the application process.

Similar forms

  • The Articles of Incorporation are similar to the LIC 309 form in that both documents require detailed information about the structure and governance of a corporation, including names of officers and directors, and they must be filed with a state agency. The Articles of Incorporation establish a corporation's existence, while the LIC 309 keeps regulatory bodies informed of current operational details.

  • The Operating Agreement for Limited Liability Companies (LLCs) shares similarities with the LIC 309 as both outline the managerial structure and operating procedures. While an Operating Agreement lays down the rules for the internal management of an LLC, the LIC 309 form provides a snapshot of these details for regulatory purposes.

  • Business License Application forms, which vary by jurisdiction, resemble the LIC 309 because they collect comprehensive information about a business for the purpose of regulatory compliance. Both forms are integral to the process of ensuring a business is legally authorized to operate within a specific area or sector.

  • Statement of Information filed with the Secretary of State, like the LIC 309, requires corporations and LLCs to report their current officers and addresses. This document keeps public records updated, similar to how the LIC 309 informs the licensing agency of current operational and structural details.

  • The Partnership Agreement parallels the LIC 309 for partnerships by delineating the roles, responsibilities, and profit-sharing arrangements among partners. Although the Partnership Agreement is more internally focused, both documents ensure that there's clear documentation of who is responsible for the management and operation of the business.

  • A Resolution to Operate or similar legal document authorizing business operations or specific actions by a corporation or public agency mirrors the LIC 309's requirement for attachments that authorize filings. These resolutions serve to document the formal decisions made by a company’s board of directors or a public body’s governing officials.

  • The Foreign Qualification documents for corporations or LLCs doing business outside the state of their incorporation share commonalities with section 7 of the LIC 309. Both require out-of-state entities to provide proof of their registration to operate legally in the foreign jurisdiction, ensuring regulatory compliance across state lines.

  • Change of Registered Agent forms, necessary when a business updates its registered agent or office, are similar to updates required on the LIC 309. Both ensure that the state and regulatory agencies have the current contact information for legal and official correspondence.

  • The Certificate of Good Standing, although not directly related in purpose, is indirectly connected to the LIC 309 in that companies may need to prove their legal and regulatory compliance status, including updates as filed in the LIC 309, to obtain or renew this certificate.

Dos and Don'ts

When completing the LIC 309 form, certain practices should be followed to ensure the application process is smooth and successful. Here’s a list of dos and don'ts:

  • Do double-check that all information is accurate as per your official documents.
  • Do attach all required documentation, including Articles of Incorporation, By-Laws, Operating Agreement and any amendments, and a Resolution authorizing the filing (for Corporations).
  • Do include a contact number and address for your California Representative if you're an out-of-state or foreign applicant.
  • Do provide the names and addresses of all persons who own a ten percent (10%) or more interest in the corporation or LLC.
  • Do list all Directors/Managers and Managing Members, including their mailing addresses, telephone numbers, and terms of office.
  • Do ensure that the name of the corporation or LLC matches exactly as filed with the Secretary of State.
  • Don't leave any section that applies to your organization incomplete.
  • Don't forget to sign and date the form.
  • Don't submit the form without reviewing it for completeness and accuracy.
  • Don't hesitate to provide additional sheets if the space provided is insufficient for any section.

Adhering to these guidelines will help avoid delays or issues with the processing of your LIC 309 form.

Misconceptions

When it comes to navigating the complexities of legal documentation for businesses within the health and human services sector in California, the LIC 309 form is a crucial document. However, there are several misconceptions about this form that need to be addressed. By clarifying these misunderstandings, entities can ensure they remain compliant with state regulations and maintain smooth operations.

  • It's only for initial registration.

    This is a common misconception. The LIC 309 form is not just for the initial registration of corporations or limited liability companies (LLCs) with the Community Care Licensing Division. It must be updated and resubmitted whenever there are changes in partners, officers, or other significant changes within the corporation or LLC, as dictated by the California Code of Regulations.

  • It applies to all business entities.

    Another misunderstanding is that the LIC 309 form applies to all business structures. In reality, this form is specifically designed for corporations and LLCs. Other entities such as public agencies, partnerships, and associations have distinct sections within the form or different forms altogether to accommodate their unique structures and needs.

  • Personal information is not required.

    Contrary to this belief, the form requires detailed personal information about the individuals who own a significant interest (ten percent or more) in the corporation or LLC. This information includes names, addresses, and in some sections, telephone numbers, ensuring transparency and accountability.

  • A copy of the resolution is optional.

    This is incorrect. For corporations, attaching a copy of the resolution authorizing the filing of the LIC 309 application is mandatory. This document supports the formal decision made by the corporation’s board of directors or other governing body to proceed with the application, demonstrating organizational compliance and authorization.

  • Out-of-state applicants are exempt.

    Out-of-state or foreign corporations and LLCs are not exempt from the requirements of the LIC 309 form. They must not only complete the form but also attach a copy of their registration to do business in California. This ensures that even entities not originally formed in California but operating within the state comply with local regulations.

  • All sections must be filled out by all applicants.

    In fact, the LIC 309 form is designed with different sections to cater to specific types of applicants - corporations/LLCs and public agencies are to fill out relevant parts that apply to their entity type, thereby not all sections are applicable to all applicants. Understanding which parts of the form apply to your organization is critical for accurate completion.

  • The form is only for health care facilities.

    While the Department of Social Services, Community Care Licensing Division, oversees a wide range of facility types, not all of them are healthcare-related. The LIC 309 is necessary for any corporation or LLC involved in the operation of facilities under the division’s purview, which may extend beyond healthcare to include community care and residential facilities.

  • Electronic submissions are preferred.

    As of the last update, the instructions do not specify a preference for electronic vs. paper submissions. The requirement is to submit an updated form when changes occur within the organization. Ensuring you follow the current submission guidelines provided by the Community Care Licensing Division is essential for compliance.

  • Immediate updates are not mandatory.

    This is a dangerous misconception. The LIC 309 form must be updated and submitted promptly with every change in partners, officers, or related changes within the corporation or LLC. Failing to provide timely updates can lead to non-compliance issues, potentially affecting the entity’s ability to operate within California.

Understanding and correctly applying the requirements of the LIC 309 form is crucial for corporations and LLCs operating in the community care and social services sectors in California. Ensuring accuracy and compliance in this area not only aligns with state regulations but also supports the broader commitment of these organizations to serve their communities responsibly.

Key takeaways

When dealing with the LIC 309 form, key takeaways are essential for ensuring that corporations, limited liability companies (LLCs), public agencies, partnerships, and other associations comply with the California Department of Social Services Community Care Licensing Division requirements. Here are seven critical points to keep in mind:

  • Update Requirements: The LIC 309 form must be updated and submitted whenever there are changes in partners, officers, or changes in the corporation or LLC as stipulated by the California Code of Regulations. This ensures the licensing agency is always informed of current organizational structure and leadership.
  • Documentation Attachment: Along with the completed form, it's necessary to attach copies of the Articles of Incorporation or Organization, By-Laws or Operating Agreement, and any amendments. Corporations need to include a copy of the Resolution authorizing the filing of this application. This documentation provides a legal basis for the application or update.
  • Principal Business Office: Clearly state the principal place of business, including the complete address and contact information. This identifies the primary location for business operations and official communications.
  • Foreign Registration: If applicable, out-of-state or foreign corporations and LLCs must attach proof of registration to do business in California. This proves the entity is legally allowed to operate within the state.
  • Ownership and Management Disclosure: Disclose names and addresses of anyone owning ten percent (10%) or more interest in the corporation or LLC, along with the directors/managers and managing members. Transparency about ownership and management structure is crucial.
  • Public Agency Requirements: For public agencies, checking the type of public agency and attaching a copy of the Resolution or legal document authorizing this application is necessary. This verification serves as official permission for the agency’s operation or service provision.
  • Partnership Agreements: If the entity is a partnership, attaching a copy of the partnership agreement is required. This detail outlines the nature of the partnership, responsibilities, and legal obligations of each partner.

Compliance with these details when filling out and submitting the LIC 309 form not only meets legal requirements but also facilitates a smoother review process by the licensing agency. Ensuring accuracy and completeness in the application can significantly affect the outcome and efficiency of obtaining or updating a license.

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