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Serious Injury Report Form A verbal report must be made immediately after the occurrence of any serious injury or death of a child. The written form below must be submitted to the Child Care Licensor
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Download the SOC 341A form from the California Department website
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Fill out the personal information section including name, address, and date of birth
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SOC 341A is a form used by the California Department of Social Services for reporting information related to individuals who own, operate, or manage an adult residential facility.
Individuals who own or operate adult residential facilities in California are required to file the SOC 341A form.
To fill out the SOC 341A form, you must provide details about the facility, including ownership, contact information, and any additional required personal or operational information as specified in the instructions provided with the form.
The purpose of the SOC 341A form is to ensure compliance with state regulations governing adult residential facilities by collecting necessary operational and ownership information.
The SOC 341A form requires reporting information such as the facility's name, address, ownership details, staff qualifications, and policies concerning resident care.
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