Forms

Document Action
PUB 394 – NOTIFICATION OF PARENTS’ RIGHTS-1View
LIC9227 – INDIVIDUAL INFANT SLEEPING PLANView
LIC9224 – ACKNOWLEDGEMENT OF RECEIPT OF LICENSING REPORTSView
LIC9222 – BLOOD GLUCOSE TESTING CONSENT/VERIFICATION CHILD CARE FACILITIESView
LIC9221 – PARENT CONSENT FOR ADMINISTRATION OF MEDICATIONS AND MEDICATION CHARTView
LIC9213 – NOTICE OF SITE VISIT BY A CHILD CARE LICENSING OFFICE REPRESENTATIVEView
LIC9212 – FAMILY CHILD CARE CONSUMER AWARENESS INFORMATIONView
LIC9150 – PARENT NOTIFICATION ADDITIONAL CHILDREN IN CAREView
LIC9149 – PROPERTY OWNER/LANDLORD CONSENT FAMILY CHILD CARE HOMEView
LIC9108 – STATEMENT ACKNOWLEDGING REQUIREMENT TO REPORT CHILD ABUSEView
LIC9040 – CHILD CARE FACILITY ROSTER (RETAIN FOR 3 YEARS) CHILD CARE CENTERS, INFANT CARE CENTERS, SCHOOL AGE CENTERS AND FAMILY CHILD CARE HOMESView
LIC995E – CAREGIVER BACKGROUND CHECK PROCESS CALIFORNIA DEPARTMENT OF SOCIAL SERVICES-1View
LIC995A – FAMILY CHILD CARE HOME NOTIFICATION OF PARENTS’ RIGHTSView
LIC702 – CHILD’S PREADMISSION HEALTH HISTORY – PARENT/AUTHORIZED REPRESENTATIVE REPORTView
LIC701 – PHYSICIAN’S REPORT-CHILD CARE CENTERS (CHILD’S PRE-ADMISSION HEALTH EVALUATION)View
LIC624B – UNUSUAL INCIDENT/INJURY REPORT – FAMILY CHILD CARE HOMEView
LIC282 – AFFIDAVIT REGARDING LIABILITY INSURANCEView
LIC 9166 – NEBULIZER CARE CONSENT/VERIFICATION CHILD CARE FACILITIESView
LIC 700View
LIC 627 – CONSENT FOR EMERGENCY MEDICAL TREATMENTView
LIC 311DView
IMM230 – CALIFORNIA IMMUNIZATION REQUIREMENTS FOR PRE-KINDERGARTENView
CDPH286 – CALIFORNIA PRE-KINDERGARTEN AND SCHOOL IMMUNIZATION RECORDView