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Section A — Licensing Application Forms ~20 min

HCS 308 Form Guide — Designee Responsibility (California HCO)

A licensee or a designee must be at the agency the whole time it is open. The HCS 308 names your designees. Each one must pass a CDSS background check.

What the HCS 308 does

HCS 281 says a licensee or designee must be continuously present during business hours. This person speaks for the agency. Their jobs include:

  • Running the agency.
  • Answering questions.
  • Getting papers from CDSS. This includes inspection reports, accusations, and civil penalties.

The HCS 308 gives designees this power.

Who can be a designee?

A staff member of your agency. You can name more than one (HCS 281).

Every person on this form must:
  • Get a CDSS background clearance or exemption, and
  • Be associated to your agency in CDSS records (HCS 281 A3).

So a friend or family member who does not work for you will not fit. Each designee needs fingerprints. See the Live Scan step after you submit.

Solo owner? You can be the licensee and the person on site. Plan who will cover when you are out. That person must be cleared too.

What goes on the form

  • Agency name, HCO number (if you have it), mailing address, county, and phone.
  • Each designee prints their name, signs, and dates it. Add their PER ID if they have one.
  • The applicant or licensee signs to give the designees this power.
Corporations: Attach a board resolution that approves these designees (HCS 281 A3). Changes later: You must tell CDSS in writing within 10 calendar days of any change (HCS 308).

Common Mistakes to Avoid

  • 1Naming a friend who does not work for you. Each designee must be cleared and associated to your agency.
  • 2Forgetting that each designee needs a background clearance.
  • 3Corporations: leaving out the board resolution.
  • 4Not telling CDSS within 10 days when a designee changes.

Tips

  • Make sure designees can reach your files. CDSS may visit when you are away.
  • Already cleared by CDSS for another job? A clearance may transfer to your agency. Ask CDSS (Steps PDF, step 6).

What You Need to Do

  1. 1
    Pick your designees (staff who will be cleared and associated to your agency)

    Everyone on the HCS 308 needs a CDSS background clearance or exemption.

  2. 2
    Complete the chain of command data fields above
  3. 3
    Generate, print, and sign the HCS 308

    Each designee signs and dates. Then the applicant or licensee signs and dates.

  4. 4
    Corporations: attach a board resolution approving these designees

    HCS 281 A3. Skip this if you are not a corporation.

Information You Will Need

Have these details ready before you sit down to fill this out:

Home Care Organization Name
Required
Home Care Organization Number (If Known)
Home Care Organization Address
Required
Designee 1 — Printed Name
Required
Designee 1 — PER ID (if any)
Designee 2 — Printed Name (optional)
Designee 2 — Job Title (for your records)
Designee 2 — Phone (for your records)
Designee 3 — Printed Name (optional)
Designee 3 — Job Title (for your records)
Designee 3 — Phone (for your records)
Name of Applicant/Licensee
Required
Title of Applicant/Licensee Signer (for your records)
Required

Documents Needed

  • HCS 308 — Designation of HCO Responsibility (pre-filled)
    RequiredPDF · Max 10MB

Official Resources

Want us to handle this for you?

Our licensing team knows this form inside and out. We fill out every form, check every box, and submit the whole packet to CDSS on your behalf. You just answer a few simple questions.

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John Helmy

Researched and reviewed by

John Helmy, Founder of HomeCareAtlas

Building tools and resources to help home care agency owners navigate licensing, compliance, and growth.