California Department of Social Services PIN 21-06-CCLD
June 1, 2021
(Supersedes PIN 19-01-CCLD)
TO: ALL LICENSED PROVIDERS
Original signed by Kevin Gaines
FROM: KEVIN GAINES
Deputy Director
Community Care Licensing Division
SUBJECT: NEW FORMS FOR COMPLAINANT INTAKE AND REPORTING NOTIFICATIONS
Provider Information Notice (PIN) Summary
PIN 21-06-CCLD announces a new form for communicating with the complainant about complaint intake, and three new forms for communicating the investigation
determination, all of which replace the Complaint Response (LIC 856) form. A revised Communication with Complainants Frequently Asked Questions (FAQ) document is also released in conjunction with the new forms. This PIN supersedes PIN 19-01-CCLD in its entirety.
Download PDF HERE