How to Fill Out and Submit LIC 9182: Criminal Background Clearance Transfer

The LIC 9182 is California’s Criminal Background Clearance Transfer Request, a one-page form that moves an active criminal record clearance from one state-licensed community care facility to another. The receiving facility’s licensee or license applicant fills it out and files it with the local Community Care Licensing Division (CCLD) regional office before the transferring person has any client contact at the new facility.¹ Miss that timing and the civil penalty is $100 per day.²

When to Use the LIC 9182

Use this form whenever someone with an existing CDSS criminal record clearance begins working at, living in, or otherwise becoming associated with a different state-licensed facility. That includes employees, administrators, corporation board members, non-client adult residents, spouses of licensees, and other people California law requires to clear a background check before client contact.³ The point of the transfer form is to avoid re-fingerprinting someone who already has a valid clearance.

Two situations fall outside this form. Transfers from the TrustLine Registry to a state-licensed facility use the TLR3 form, and transfers going the other way require you to call TrustLine at (800) 822-8490 for instructions. Transferring a criminal record exemption, rather than a clearance, uses the LIC 9188.¹

Where to Get the Current Form

Download the LIC 9182 from the CDSS forms library under the I–L alphabetic listing, or from the Caregiver Background Check section of the CDSS website.⁴ Your local CCLD regional office can also provide a copy. The form was revised in 2023, so confirm you have the current version rather than a saved copy from before that update.⁵

How to Complete Each Section

The form has four parts plus a signature line. It asks only for identification and routing information, so none of it should take long if you have the person’s clearance information in front of you.

Individual Information

Enter the person’s last name, first name, and middle initial exactly as they appear in the Licensing Information System. Then add their California driver’s license number, state ID number, or Permanent Resident ID (I-551), their date of birth, and their Licensing Information System ID number from the original background check. If you don’t know the LIS ID, your local CCLD office can confirm it. The Social Security number field is optional.³

From Facility / Organization

List the facility the clearance is leaving: name, CDSS-assigned facility number, and full street address with city, state, and zip code.

To Facility / Organization

List the receiving facility’s name, facility number, address, and the individual’s start date or anticipated start date. Then check one Transferee Association Type from the form’s list: Facility Administrator, Corporation Board Member, Employee, Certified Home, Licensee/Applicant, Non-client Adult Resident, Partnership Member, Spouse of Licensee, or Affiliated Home Care Aide. If the same person needs the clearance moved to more than one facility at once, you can attach a list of additional facility numbers to a single LIC 9182 instead of filing separate forms.¹

Out-of-State Criminal Activity (OSCA)

The 2023 revision added this section for transfers to a children’s residential program facility. The individual reports whether they have lived in another state within the past five years so CDSS can run an out-of-state criminal activity check. It does not apply to Foster Family Agency staff, Youth Homelessness Prevention Centers, Private Alternative Boarding Schools, Private Alternative Outdoor Programs, or Crisis Nurseries.⁵

Signature

The licensee, administrator, or director at the receiving facility signs the form and certifies that they verified the individual’s identity. The person whose clearance is being transferred does not sign.³

What to Attach

In most cases, nothing. The 2023 update removed the old requirement to attach a Criminal Record Statement (LIC 508) and a copy of the person’s photo ID. The LIC 508 has been discontinued entirely.⁵

One exception: if the transfer is to a facility that serves children and the individual has never had a Child Abuse Central Index (CACI) check, or the last CACI inquiry was before January 1, 1999, a new CACI check is required. That request goes directly to the California Department of Justice with the applicable fee, not to CDSS.³

Where and When to File

Send the completed LIC 9182 to your local CCLD regional office.¹ It must reach CDSS before the person has any client contact at the new facility. There is no grace period.

If you’re not sure the clearance is still active, call your local CCLD office to confirm before you file. Only active clearances can be transferred.

After You Submit

The person can start work and be present in the facility as soon as the form is submitted. You don’t have to wait for CDSS to confirm the transfer, as long as the form went in before client contact began.¹

Do not re-fingerprint someone whose clearance is active. Sending in new prints when a valid clearance already exists can delay the transfer.¹

Penalty for Late Submission

Letting someone have client contact before the LIC 9182 is submitted carries a civil penalty of $100 per violation per day, capped at five days. A second occurrence within twelve months stays at $100 per day but extends the cap to 30 days. Repeat violations can also trigger disciplinary action against the licensee under Health and Safety Code Section 1550. The penalties fall on the licensee, not on the person whose clearance was supposed to be transferred.²

County-to-State and Similar Transfers

Clearances can move between contracting county licensing agencies and state licensing agencies within the same licensing category. A clearance can shift from one county-licensed Foster Family Home to another, or from a county-licensed Foster Family Home to a state-licensed one. Certified Family Homes count as the same facility type as licensed Foster Family Homes for this purpose, so transfers between Foster Family Agency certified homes and county-licensed Foster Family Homes are allowed.¹

When the Clearance Has Gone Inactive

A clearance does not stay active forever. If the person has been disassociated from all licensed facilities for more than three years, the clearance goes inactive and they must be fingerprinted and cleared again before working or volunteering at any licensed facility.⁶ The LIC 9182 only works for active clearances; it cannot revive one that has lapsed.

1
California Department of Social Services. Transferring a Clearance to a New Facility
2
California Legislative Information. California Health and Safety Code HSC 1522
3
California Department of Social Services. Criminal Background Clearance Transfer Request (LIC 9182)
4
California Department of Social Services. Forms and Publications (I-L)
5
California Department of Social Services. PIN 23-08-CCLD – Criminal Background Clearance Transfer Request (LIC 9182) and Criminal Record Exemption Transfer Request (LIC 9188) Form Updates
6
California Department of Social Services. Background Check Process