The Physician's Report for California Assisted Living, Explained

Assisted living communities and board and care homes are licensed in California as residential care facilities for the elderly (RCFEs). Before one accepts a resident, Title 22, section 87458, requires it to obtain documentation of a medical assessment and keep it in the resident's record.

The state's form for this is LIC 602A, titled Medical Assessment for Residential Care Facilities for the Elderly. The copy the California Department of Social Services had posted on October 13, 2026 is dated 4/26. A department notice dated May 27, 2025 announced the renamed form. It says the form was formerly called the Physician's Report for Residential Care Facilities for the Elderly, and that the word physician was removed so other licensed medical professionals can complete it.

Two things cause mix-ups. The department also posts LIC 602 (7/22), Physician's Report for Community Care Facilities, a general form for other kinds of licensed care, and some older state forms still point to it. And LIC 602A says it is provided as a courtesy, so a home may hand you its own medical assessment form instead. Ask the home which one it wants.

The regulation asks for a medical assessment signed by a licensed medical professional acting within the scope of their practice. In its 2025 questions and answers on the rule changes, the department gives a physician, physician assistant or nurse practitioner as examples of a licensed medical professional.

The assessment must have been made within the last year. That is the state's outer limit, and a home may ask for something more recent. The home must also obtain an updated assessment whenever the licensing agency requires one.

A note at the top tells the professional that the person is moving to, or lives in, a home that provides mainly non-medical care and cannot provide skilled nursing care, and that the answers help decide whether the person is appropriate for that setting. The form then runs in five parts:

1. 1

   Part I: the home

   The home fills in its name, contact person, phone, email and address.

2. 2

   Part II: your parent

   Name, date of birth, age and address, completed by the prospective resident or their legal representative.

3. 3

   Part III: release of medical information

   The prospective resident or legal representative signs to authorize release of the information in the report to the home named in Part I.

4. 4

   Part IV: the medical findings

   The licensed medical professional records the date of the exam, height, weight and blood pressure, then works through the clinical sections described below.

5. 5

   Part V: the professional

   Name, address, phone, email, how long they have provided care to the person, signature and date.

Part IV is most of the nine pages. For each condition it asks what it is, the treatment, medication or equipment involved, and whether the person can manage that on their own. If not, the professional describes the help needed.

These are the sections, in the order they appear:

• Diagnoses, then cognitive conditions. The form prints definitions of mild cognitive impairment and major neurocognitive disorder, which includes Alzheimer's disease and related disorders.
• Results of the exam for communicable tuberculosis, then infectious diseases, contagious diseases, other medical conditions and allergies.
• Overall physical health, with yes or no lines such as hearing and vision loss, special diet, incontinence, help with repositioning and transferring, and any history of skin breakdown.
• Capacity for self-care: bathing, dressing, eating, toileting, managing cash, communicating, following directions, and whether the person can leave the home unsupervised, considering cognitive abilities.
• Overall mental health, and behavioral expressions such as disorientation, lack of hazard awareness, wandering, leaving the home unsupervised, and hallucinations.
• Access to items: whether anyone's safety would be at risk if the person could reach things like cleaning products, sharp objects or matches, and whether supervision is needed near stoves, heaters or pools.
• Medication management: whether the person can take their own prescription and as-needed medications, give their own injections, test their own glucose, use their own oxygen and store their own medications.
• Ambulatory status, and whether the person is receiving hospice care.

Only the medical professional answers these. Your part is to bring a current medication list and an accurate account of what you see at home. The home compares the findings with the state's rules on restricted and prohibited conditions, which we explain in health conditions assisted living can accept.

The regulation requires the results of an examination for communicable tuberculosis. On the form this is a short block with five entries: the date the TB test was given, the date it was read, the type of test, the result, and the action taken if the result was positive. The form does not say which type of test must be used.

It matters because the regulations bar a home from accepting or keeping a person who has active communicable tuberculosis. The department's 2025 questions and answers note that people living in shared settings such as RCFEs are at increased risk of TB exposure.

A home may have its own policy on which test it accepts and how old the result may be. Ask before the appointment, then let the doctor decide which test is appropriate. Our guide to move-in requirements shows where this fits among the other steps.

The last clinical section asks whether the person can transfer to and from bed independently, and whether, for the purposes of a fire clearance, they are ambulatory, nonambulatory or bedridden. The form prints the definitions. Nonambulatory means unable to leave a building unassisted in an emergency, which includes people who depend on a walker or wheelchair. Bedridden means needing assistance to turn or reposition in bed.

The regulation also asks whether nonambulatory status comes from a physical condition, a mental condition or both. If the person is bedridden, the form asks the cause and how long it is expected to last, and notes that an illness or recovery is considered temporary if it will last 14 days or less.

The form itself says these boxes are for the purposes of a fire clearance, so ask each home what its clearance allows.

The home must evaluate the assessment before it accepts your parent. It is one input to the home's own written appraisal, covered in the pre-admission appraisal form explained. The regulation also asks the professional for a record of current prescribed medications and whether they should be centrally stored by the home.

Before you hand it over, check that every page is there, that the TB block has dates and a result, and that Part V is signed and dated. Keep a copy. For where this form sits among the others, see the state forms families see.

Hamssa Benrekia is a senior living placement specialist in Torrance with a background in hospice, palliative care and home health. She helps families in the South Bay and Harbor area of Los Angeles County with assisted living placement and with moves that start in a hospital, described on her hospital discharge placement page. She can tell you which version of the form the homes on your list ask for and how recent they want it. The medical answers belong to the doctor.

To talk through timing, contact Hamssa. For the rest of the decision, see the California Assisted Living Placement Guide.