Section A — Licensing Application Forms ~60 min

LIC 508 Criminal Record Statement for California Home Care License

All owners with ≥10% ownership and all Designees must complete a LIC 508 criminal record statement.

LIC 508 requires disclosure of any criminal history. The table below shows exactly who needs to submit this form.

CDSS uses this to conduct background checks. Certain offenses may be disqualifying, but CDSS evaluates each case individually.

This tool does not provide legal advice on what disqualifies an applicant.

Common Mistakes to Avoid

  • 1Missing a form for someone who qualifies (check the table carefully)
  • 2Incomplete disclosure of criminal history

Tips

  • Each person downloads and completes their own LIC 508
  • Upload one form per person — use the table below to track who has completed theirs

What You Need to Do

  1. 1
    Download LIC 508 form for each required person
  2. 2
    Complete and upload LIC 508 for all required people (see table below)

Documents Needed

  • LIC 508 - Criminal Record Statement
    RequiredPer PersonPDF, JPG, PNG · Max 10MB

Official Resources

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