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PDF Assisted Living Facility Application – 384kb

Be sure to send us the following documents with the application.

  1. Copy of your last State of CA Facility Evaluation Report and any plan of correction resulting from Deficiency Citations If any.
  2. Copy Of Your Current Facility License.
  3. Copy Of Your Current Policy Declaration Page if you you are currently insurance, if you are not currently insured disregard this request.
  4. Copy`s Of Current Valued 5 Years Loss History, can be requested from your current Broker/Agent, If No Prior Insurance disregard this document request.
  5. Copy of your marketing brochure or Advertising.