STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ABOUT THE LIC 624-LE
THE LAW: In accordance with section 1538.7(a) of the Health and Safety Code, “A group home, transitional housing place-
ment provider, community treatment facility, runaway and homeless youth shelter, or short-term residential therapeutic
program shall report to the department’s Community Care Licensing Division upon the occurrence of any incident concerning
a child in the facility involving contact with law enforcement.” Within six months of the incident, the facility must “provide a
follow-up report for each incident, including the type of incident, whether the incident involved an alleged violation of any
crime described in Section 602 of the Welfare and Institutions Code by a child residing in the facility; whether staff, children,
or both were involved; the gender, race, ethnicity, and age of children involved; and the outcomes, including arrests, removals
of children from placement, or termination or suspension of staff.”
Crimes described in Section 602 of the Welfare and Institutions Code are “any law of this state or of the United States or any
ordinance of any city or county of this state defining crime other than an ordinance establishing a curfew based solely on
age.”
AFFECTED FACILITIES: Group Homes, Community Treatment Facilities, Transitional Housing Placement Providers, Runaway
and Homeless Youth Shelters, and Short-Term Residential Therapeutic Programs must make reports under the law.
HOW, WHAT AND WHEN TO REPORT: Affected facilities may (but are not required to) use the LIC 624-LE to report incidents
under the law. If a facility uses another method to report an incident, that method must capture all of the information specified
by Health and Safety Code section 1538.7(a), and must be submitted within the time allowed by the law. A facility must
submit a report on every incident which involves a law enforcement contact, whether or not any child is alleged to have
committed a crime. The follow-up report for an incident must be filed within six months, but may be filed sooner (including
concurrently with the initial report) provided all outcomes resulting from the incident are known.
*RACE AND ETHNICITY. One of the following races must be selected for each child listed in Part 2 of this form: White,
Black, Native American, Asian/Pacific Islander, Other, or Unknown. One of the following ethnicities must be selected for
each child listed in Part 2 of this form: Hispanic, Non-Hispanic or Unknown.
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LIC 624-LE (4/17)