You are free to move forward with your home daycare business. Child Care Checklist - Child Development (CA Dept of Education) The Child Care Licensing Program provides oversight and enforcement for licensed Child Care Centers and Family Child Care Homes through 19 Regional Offices located throughout California. All children and families, regardless of age, ethnicity, cultural background, gender, socioeconomic status, or ability, are afforded the same protections under law and regulations for child care facilities. Find online child care inspection reports by selecting your state or territory on the " See Your State's Resources " page and selecting the "Understanding and Finding Child Care" tab. You may also have an inspection by a Fire Marshall. The Compliance and Regulatory Enforcement (CARE) Tools, developed as part of the Inspection Process Project, are for use in the Adult and Senior Care (ASC) Program, Children's Residential Program and Child Care Program. Conversion of a garage (either attached or detached) into a child care room. Thats why weve created state-specific guidesso youll know exactly what the requirements are to start your home daycare. But we recommend waiting 3 to 6 months to sit down with a CPA to discuss quarterly tax payments. TrustLine may be reached at 1-800-822-8420. Smoking Prohibition It wont do much good to get people talking about your daycare business if you dont have anywhere for them to go to check you out online. You must undergo a pre-licensing inspection. You have the option of attending the orientation online or in person, normally. After that, youll send a contract, get their deposit, and enroll their child in your program. Become an asset to your community and start your Californian Daycare with the help of our startup course and documents. CocoDoc collected lots of free Home Inspection Checklist Template for our users. The Licensing Process Eligibility Training Requirements Home Requirements High level characteristics of Family Child Care Homes in California: Care must be provided in the licensee's own home Licensee must live in the home Care provided is less than 24 hours FIND CHILD CARE NEAR ME Training Requirements. Child Care Advocates - (916) 654-1541 Medicines, poisons, firearms, knives, cleaning chemicals are stored away out of the children's reach. 7 Important Child Care Director Resources. There will be references made to these during the session. Meet Shawn Chun: Entrepreneur and Childcare Business Fan. Information regarding filing a complaint, Copyright 2023 California Department of Social Services. If you are considering opening a Family Child Care Home, ask yourself the following questions: If so, Family Child Care may offer you a rewarding and challenging career opportunity. The reason for the denial will be indicated. Depending on the outcome of that inspection, you may be just about done with your licensing process. Others are still using paper and pen. In many states, being a parent is enough, and many of our most successful providers are moms with young children at home. ca inspection. The Checklist is user-friendly, easy-to-understand and has links to theCaring for Our Childrenstandards and other related resources. The most common issues found in California homes are water damage or leaky roofs. This post is a part of our series on California family child care licensing. Checklists | California Child Care Licensing: Your Go-To Guide The Department of Motor Vehicles offers a license plate that can help our kids. California family child care licensing: Types of licenses Community Care Licensing requires that homes in which day-care is provided for from nine to fourteen children pass a fire clearance inspection prior to being licensed. By getting your space ready now, youll be able to move through licensing more quickly and can open as soon as you get your license. The core mission of the Child Care Licensing Program is to ensure the health and safety of children in care. Food All rights reserved. Create cubbies or hooks for each child to store jackets, shoes, backpacks, and anything else they bring from home. Do the foundation and walls of this house need repairs? Take some time to think through your story and how you might share it with families. In this go-to guide, we will describe the differents types of child mind licensing in California, real how until choose one right of for your business. A home inspection uncovers any defects in the property or safety hazards that a resident may face. Single family homes can generally qualify for a large license since they often have a front entry, a back entry to a backyard, and then a gate exit from the backyard to the street. Since 1978, the mission of AFS has been - and continues to be - to support vulnerable children and families in need of . The only instance when a home inspection is not required is when selling a house as is in California. Anything you can do to speed up your process is a good idea. For more on licensing in California, see the following posts: California Family Child Care Licensing: An Overview PDF CAL FIRE - Office of the State Fire Marshal Information - California Every states requirements may be slightly different. Senior Care Licensing For older children, youll provide a mat or cot, and you need to be able to space them out. In some cases, the amendments to your property may cost you a bit of money. PDF Residential Large Family Daycare Facilities - OCFA Improving the effectiveness and quality of the inspection process, which includes developing and deploying comprehensive, data-driven inspection tools is essential to these efforts. Coronavirus General Question Inbox: CCLCOVID-19INFO@dss.ca.gov, Community Care Licensing Division Get the guide to learn how to open a daycare in your state. The CCLD provides oversee of parent care centers in the state, helping to deliver child care orientation, inspections and other supports for child care operators. In lieu of locked storage of firearms, the licensee may use trigger locks or remove the firing pin. Does this house need any specialized inspection? Alternative Family Services. Family Child Care Home Licensing Information - California Dept. of Child Care Licensing Program We recommend Sole Proprietorship, which is the most common way for small businesses in the US. If the provider does not own the premises used as the family child care home, the affidavit shall also state that the parent has been informed that the liability insurance, if any, of the owner of the property or the homeowners association, as appropriate, may not provide coverage for losses arising out of, or in connection with, the operation of the family child care home, except to the extent that the losses are caused by, or result from, an act or omission by the owner of the property or the homeowners association, for which the owner of the property or the homeowners association would otherwise be liable under the law. Also, you can lower the asking price by leveraging the defects found in the real estate inspection report. Email: info@cccf-fcsge.ca. Youll take this with you whenever you and the kids leave the property. One CCLD provides oversight of child care . Youre set up for success. Others are still using paper and pen. You may admit a child who lacks documentation of having received all the required shots and who does not have a permanent medical exemption or personal beliefs exemption to immunization if he or she has not received all the shots required for his or her age group and he or she has started receiving doses of all required vaccines as follows: Polio #2 2 months after first dose In this situation, the applicant will be notified within 30 days of the receipt of their application. Youre set up for success. Although get, specifically, will home inspectors are looking for? A family child care home that maintains liability insurance or a bond, and that provides care in premises that are rented or leased or uses premises which share common space governed by a homeowners association, shall name the owner of the property or the homeowners association, as appropriate, as an additional insured party on the liability insurance policy or bond if all of the following conditions are met: Proof of Control of Property at the Family Child Care Home Web Address: www.cccf-fcsge.ca. In both cases, small and large, you must pass a home inspection from the California Community Care Licensing Department. 2022 Higher Ground Education Inc. - All Rights Reserved. Lastly, most lenders recommend a property inspection report before sanctioning your loan. There are some cases where a license could be denied. That way, you can relax going into the weekend and know that your daycare will be clean for the new week ahead. 5 Overview of Estimated Fees .. There are 2 types of real estate inspections, general and specialized. Mom to Hudson & Brooks, Whether its your backyard or a nearby park, having a designated outdoor area is important. California Child Care Licensing: Your Go-To Guide | Procare Solutions A signed and dated copy of LIC 9052 (4/88), Notice of Employee Rights, shall be maintained in the employees personnel record. 744 P Street, MS T9-15-48 Types of Licenses You can prove you have this experience with letters of reference on company letterhead or a resume with the contact information of people who can verify your experience. Dont forget to keep receipts whenever you spend money for the program. Phone: 1-800-858-1412. Youll start paying once youre up and running with enrollments, based on how much profit you expect to generate in a calendar year. Before youll be granted your license, youll have a scheduled site visit when youre all set up and pretty much ready to open. FAMILY CHILD CARE HOMES: A Family Child Care Home must be in the licensee's own home. SCOPE LetUsNo@dss.ca.gov The licensee shall be permitted to exempt a child from this requirement provided that one of the following requirements is met and the documentation is kept in the childs file: A child who does not meet any of the requirements mentioned above shall not be admitted to a family day care home. DTP #2 and #3 2 months after previous dose b. Garage. Every infant and toddler requires a highchair. Sacramento, CA 95814 The fees collected from the Kids Specialty License Plates are deposited in the Child Health and Safety Fund and used for programs that keep California kids safe, which include child care safety, child abuse prevention, and efforts to prevent childhood injuries. You also need to follow all of the instructions for adding any other paperwork that is required of you to be granted a home daycare license. Department of Children, Youth & Families - theverticals.com It involves online trainings, background record checks, and a home inspection. Reconsider your purchase based on the severity of the issues, and not on the number in the inspection report. Having tools and toys that support the growth of children in your care is crucial. Whether you rent or own your home, its important to begin setting up your space at the start of the licensing process. Creating clear and consistent expectations for licensees to address issues in real-time to ensure the health and safety of the individuals that are served and provide technical assistance to licensees on statutory and regulatory requirements. There are going to be differing qualifications in various parts of California. You must be familiar with all Family Child Care Home licensing laws and regulations. The manufacturers rated seating capacity of the vehicle shall not be exceeded. Safe Toys and Equipment Just looking forgeneralinfo? We and our partners share information on your use of this website to help improve your experience. All providers should take out a separate General Liability insurance policy. California Child Care Licensing: Your Go-To Guide | Procare Solutions Likewise, you can back out of the deal if the severity of the defects is high. Thats where you come in. The final determination as to whether your home qualifies for a large license or not will depend on the fire marshals inspection. Complete your required hours of certified continuing education. Fire clearance. Then create flyers and business cards that you can post on local bulletin boards and hand out at farmers markets, PTO meetings, or even your own childs soccer game. The Family Child Care Home licensing requirements are available on our Laws and Regulations page. How to Ace Your Home Inspection - NeighborSchools | Office of the State You can use thisself-assessment guideto make sure you are prepared for the inspection. The Licensing Process You actually dont need a degree to own your own daycare. The Checklist includes 72 out of the 138 key health and safety standards inStepping Stones Third Edition. You can use thisself-assessment guideand thePre-Licensing Readiness Guide Family Child Care Hometo make sure you are prepared for the inspection. Do you think there are some concerning defects in the property that could be a safety hazard? Child Care Center Checklist . So, lets go through the steps with a little more detail. Does the inspection report come with pictures. Each states licensing process is different. If the inspector finds there are things you need to make changes to or updates that need to be made to the home or the yard, you will have to agree to get them taken care of. . Stairways have non-pressure safety gates. Your daycare needs to include a bathroom, with a sink, step stool, and toilet for children who are out of diapers. It's worth noting that states use different terms to refer to home daycare. Problems with downloading forms? Installation of in-ground or above-ground swimming pools, spas, fish ponds, decorative water feature, fountains or other bodies of water. Providing LPAs with a compendium of inspection's tools to ensure inspections are thorough and consistent; bolstering the LPA Training Academies; and deploying ongoing staff training and data analytics to target resources in priority areas. Prior to making alterations or additions to a family child care home or grounds, the licensee shall notify the Department of the proposed changes, including, but not limited to, the following: The licensee shall provide the Department with a copy of an inspection report when an inspection is required by the local building inspector as a result of the alteration, addition or construction. Adult Care Licensing And theres never been a better time to start a home daycare: families desperately need more child care options, especially infant and toddler programs. This is especially true if youre going to open a home daycare business. That includes finding someone to do the work and then paying for it. Alternative Family Services (AFS) provides thoughtful, informed foster care, adoption and mental health services throughout California's San Francisco Bay Area and Greater Sacramento region. Tips for Using Adobe PDF Files, Copyright 2023 California Department of Social Services, ICPC 100A Instructions (7/20) Instructions For Completing Form ICPC 100A Interstate Compact On The Placement Of Children Request, ICPC 100A (11/20) Interstate Compact On The Placement Of Children Request, ICPC 100B Instructions (7/20) Instructions For Completing Form ICPC 100B Interstate Compact Report On Childs Placement Status, ICPC 100B (7/20) Interstate Compact On The Placement Of Children Report On Childs Placement Status, IHSS-E 002 (1/17) - In-Home Supportive Services (IHSS) Program Notice To Provider For Discontinuance Of Exemption From Workweek Limitations For Extraordinary Circumstances, IHSS-E 003 (1/17) - In-Home Supportive Services (IHSS) Program Notice To Recipient For Discontinuance Of Exemption From Workweek Limitations For Extraordinary Circumstances, IHSS-E 004 (4/17) - In-Home Supportive Services Program Notice Of Non-Receipt Of Exemption From Workweek Limits Provider Agreement (APD 006), IHSS-E 005 (1/17) - In-Home Supportive Services Program Notice Of Ineligibility To Request Exemption From Workweek Limits For Extraordinary Circumstances (Exemption 2) - Provider, IHSS-E 006 (4/17) - In-Home Supportive Services Program Notice To Provider Of Expiration Of Exemption From Workweek Limits, IHSS-E 007 (4/17) - In-Home Supportive Services (IHSS) Program Notice To Recipient Of Providers Expiration Of Exemption From Workweek Limits, KG 1 (12/11) - Kin-GAP Mutual Agreement For 18 Year Olds, KG 2 (1/11) - Statement Of Facts Supporting Eligibility For Kinship Guardianship Assistance Payment (Kin-GAP) Program, KG 3 (12/11) - Kin-GAP Mutual Agreement For Nonminor Former Dependents, KG 4 (2/14) - Kinship Guardianship Assistance Payment (Kin-GAP) Program - Nonrecurring Legal Guardianship Expenses Agreement, KG 5 (2/14) - Kinship Guardianship Assistance Payments (Kin-GAP) Program Nonrecurring Legal Guardianship Expenses Form, LIC 00 (8/17) - Conversion to Resource Family: Release of Information, LIC 00A (2/17) - Conversion - Resource Family Application, LIC 01A (6/23) - Resource Family Application, LIC 01C (7/16) - Resource Family Application-Confidential, LIC 03 (8/21) - Resource Family Home Health And Safety Assessment Checklist Document For Agency Use Only, LIC 05A (8/21) - Resource Family Approval Certificate, LIC 12 (8/21) - Resource Family Approval Document Alternative Plan (DAP), LIC 102 (9/99) - Sanitation Inspection Request, LIC 107 (9/00) - Applicant Fingerprint Follow-Up Request, LIC 125 (3/21) - Entrance Checklist - Child Care Centers, LIC 126 (3/21) - Entrance Checklist - Family Child Care Homes, LIC 165 (8/07) - Board Of Directors Statement, LIC 178 (12/15) - Deficiency/Penalty Review, LIC 184 (5/00) - Notification Of Incomplete Application, LIC 184A (1/08) - Notification Of Incomplete Foster Family Home Application, LIC 184B (3/23) - Notification Of Incomplete Application - Family Child Care Home, LIC 184C (3/23) - Notification Of Incomplete Application (NOIA) Child Care Centers -Pre-30-Day NOIA, LIC 184D (3/23) - Notification Of Incomplete Application (NOIA) Child Care Centers - 30-Day NOIA, LIC 184E (3/23) - Notice Of Incomplete Application (NOIA) Changes To Corporate Status, LIC 186A (10/04) - Orientation Meeting Family Child Care Home, LIC 192 (7/03) - Notification Of Initial Application Denial, LIC 195 (8/19) - Notice Of Operation In Violation Of Law, LIC 195A (8/19) - Notice Of Operation In Violation Of Law - Family Child Care Home, LIC 198 (1/22) - Child Abuse Central Index Check For County Licensed Facilities, LIC 198B (8/21) - Out-Of-State Child Abuse/Neglect Report Request, LIC 200 (2/11) - Application For A Community Care Facility or Residential Care Facility For The Elderly License, LIC 200TM (6/18) - Temporary Manager Application For Provisional License, LIC 200A (2/17) - Application for a Child Care Center License, LIC 201F (2/01) - Annual License Fee Notice - County, LIC 215TM (11/18) - Temporary Manager Candidate List Application Information, LIC 216TM (11/18) - Temporary Manager Appointment Applicant Information, LIC 229 (9/99) - Certificate Of Approval (For Certified Family Homes), LIC 279 (2/23) - Application For A Family Child Care Home License, LIC 279A (5/17) - License Application And Instructions For Family Child Care Homes, LIC 279B (1/22) - Current Children In Your Home - Application For A Family Child Care Home License, LIC 281 (9/04) - Application Instructions for A Facility License, LIC 281A (1/07) - License Application And Instructions For Child Care Centers, LIC 281D (1/17) - Application And Supporting Documentation Checklist Foster Family Agency, LIC 281E (1/17) Application And Supporting documentation Checklist Short - Term Residential Therapeutic Program, LIC 282 (1/22) - Affidavit Regarding Liability Insurance For Family Child Care Home, LIC 283 (4/10) - Foster Family Home Application, LIC 283A (12/07) - Foster Family Home Application Instructions, LIC 300A (01/22) - Removal Confirmation - Exemption Needed, LIC 300B (9/03) - Removal Confirmation - Denial, LIC 300C (9/03) Removal Confirmation Rescinded, LIC 300D (9/03) - Removal Confirmation Non-Exemptible, LIC 300E (12/03) - Removal Confirmation - County, LIC 301A (8/07) - Reference Request - Adoption Facilitator, LIC 301B (8/07) - Reference Request - Long-Term Care Ombudsman Program, LIC 301E (10/22) - Reference Request - Exemption, LIC 306 (3/01) - Reporting Requirements By Licensees To The State Department Of Social Services, LIC 308 (11/02) - Designation Of Facility Responsibility, LIC 309 (6/01) (PUBLIC) - Administrative Organization, LIC 311A (2/22) - Records To Be Maintained At The Facility - Child Care Centers, Infant Centers, School-Age Centers and Child Care Centers For Mildly Ill Children, LIC 311B (4/05) - Records To Be Maintained By The Facility - Group Homes, LIC 311C (4/05) - Records To Be Maintained At The Facility - Adult Residential, LIC 311D (2/22) - Forms/Records To Keep In Your Family Child Care Home, LIC 311E (4/05) - Records To Be Maintained At The Facility - Small Family Home And Foster Family Home, LIC 311F (4/05) - Records To Be Maintained At The Facility - Residential Care Facility For The Elderly, LIC 313 (12/01) - Evidence Of Program Consultant, LIC 400 (1/99) - Affidavit Regarding Client/Resident Cash Resources, LIC 401 (3/01) - Monthly Operating Statement, LIC 401A (3/99) - Supplemental Financial Information, LIC 403A (9/11) - Balance Sheet Supplemental Schedule, LIC 404 (7/99) - Financial Information Release And Verification, LIC 405 (8/01) - Record Of Client's/Resident's Safeguarded Cash Resources, LIC 406 (5/13) - Client/Resident Cash Sheet, LIC 421A (6/22) - Civil Penalty Assessment (Unlicensed Facility), LIC 421BG (5/19) - Civil Penalty Assessment Caregiver Background Check, LIC 421CC (6/22) - Civil Penalty Assessment Child Care, LIC 421D (ASC) (6/17) - Civil Penalty Assessment Death/Serious Bodily Injury/Physical Abuse (ASC), LIC 421D (CC) (8/22) - Civil Penalty Assessment Death/Serious Injury/Physical Abuse (Child Care), LIC 421D (CRP) (6/17) - Civil Penalty Assessment Death/Serious Bodily Injury/Physical Abuse (CRP), LIC 421FC (7/17) - Civil Penalty Assessment Failure To Correct And Repeat Violations, LIC 421IM (7/17) - Civil Penalty Assessment Immediate $500 And Repeat Violations, LIC 422 (9/11) - Notice Of Civil Penalties Due, LIC 424 (1/03) - Record Of Client's Cash Resources For Change Of Licensee, LIC 503 (3/99) - Health Screening Report - Facility Personnel, LIC 507 (1/00) - Facilities Staff Work Schedule, LIC 508 (7/21) - Criminal Record Statement & Out-Of-State Disclosure, LIC 508 O-O-S (2/20) - Out-Of-State Disclosure, LIC 508A (3/11) - Criminal Record Statement - Adoption Facilitator, LIC 508B (3/11) - Criminal Record Statement - Long-Term Care Ombudsman Program, LIC 508D (11/22) - Out-Of-State Disclosure And Criminal Record Statement, LIC 601 (8/08) - Identification And Emergency Information, LIC 602 (7/22) - Physician's Report For Community Care Facilities, LIC 602A (8/11) - Physician's Report For Residential Care Facilities For The Elderly (RCFE), LIC 603 (6/22) - Preplacement Appraisal Information, LIC 604 (10/05) - Admission Agreement Guide For Residential Facilities, LIC 604A (2/05) - Admission Agreement For Residential Care Facilities For The Elderly, LIC 605A (7/22) - Release Of Client/Resident Medical Information, LIC 606 (8/18) - Residential Care Facility For The Elderly Disclosure Worksheet, LIC 610 (10/03) - Emergency Disaster Plan For Child Care Centers, LIC 610A (01/22) - Emergency Disaster Plan For Family Child Care Homes, LIC 610B (6/02) - Emergency Plan For Foster Family Homes, LIC 610C (10/03) - Emergency Disaster Plan For Children's Residential Facilities (Except Foster Family Homes), LIC 610D (12/21) - Emergency Disaster Plan For Adult Day Programs, Adult Residential Facilities, Residential Care Facilities For The Chronically Ill And Social Rehabilitation Facilities, LIC 610E (3/19) - Emergency Disaster Plan For Residential Care Facilities For The Elderly, LIC 613 (12/02) - Personal Rights Adult Residential Care Facilities, LIC 613A (8/08) - Personal Rights - Child Care Centers, LIC 613B (6/22) - Personal Rights Childrens Residential Facilities, LIC 613C (1/19) - Personal Rights Of Residents In Publicly Operated Residential Care Facilities For The Elderly, LIC 613C-2 (1/19) - Personal Rights Of Residents In Privately Operated Residential Care Facilities For The Elderly, LIC 621 (4/99) - Client/Resident Personal Property And Valuables, LIC 622 (9/19) - Centrally Stored Medication And Destruction Record, LIC 622A (6/17) - Medication Administration Record (MAR), LIC 622B (5/17) - Psychotropic Medication Administration Record (MAR), LIC 623 (5/01) - Group Planned Activities, LIC 624 (4/99) - Unusual Incident/Injury Report, LIC 624B (8/08) - Unusual Incident/Injury Report - Family Child Care Home, LIC 624 LE (12/22) - Law Enforcement Contact Report, LIC 625 (11/19) Appraisal/Needs and Services Plan, LIC 627 (9/08) - Consent For Emergency Medical Treatment - Child Care Centers Or Family Child Care Homes, LIC 627A (9/08) - Consent To A Medical Examination, LIC 627B (9/08) - Consent For Emergency Medical Treatment - Children's Residential Facilities, LIC 627C (4/00) - Consent For Emergency Medical Treatment - Adult And Elderly Residential Facilities, LIC 700 (10/19) - Identification And Emergency Information Child Care Centers/Family Child Care Homes, LIC 701 (8/08) - Physician's Report - Child Care Centers, LIC 701A (9/00) - Gastrostomy - Tube Care: Physician's Checklist (Child Care Facilities), LIC 701B (9/00) - Gastrostomy - Tube Care Consent/Verification (Child Care Facilities), LIC 702 (10/19) - Child's Preadmission Health History - Parent/Authorized Representative Report, LIC 808 (12/20) Plan For Epidemic Outbreak Specific to COVID 19 Mitigation Plan Report, LIC 809 (12/15) - Facility Evaluation Report, LIC 812 (8/06) - Detail Supportive Information, LIC 813 (11/99) - Facility Photography Report, LIC 856A (3/21) - Complaint Intake Notification, LIC 856B (3/21) - Complaint Determination Notification - Substantiated, LIC 856C (3/21) - Complaint Determination Notification - Unsubstantiated, LIC 856D (3/21) - Complaint Determination Notification - Unfounded, LIC 857 (8/06) - Children's Record Review, LIC 858 (10/99) - Client/Resident Records Review, LIC 858A (7/00) - Additional Child Records Review For Specialized Foster Care Homes, LIC 859 (8/06) - Review of Staff/Volunteer, LIC 860C (12/02) - Facility Review Index Foster Family Homes, LIC 861 (1/03) - Prelicensing In-Home Interview, LIC 907 (5/00) - Transmittal For Processing, LIC 972 (5/00) - Individual Waiver/Exception Log, LIC 973 (4/03) - Documented Alternative Plan - Foster Family Homes (Bedrooms), LIC 974 (4/03) - Documented Alternative Plan - Foster Family Homes (Telephones), LIC 986A (10/99) - Notice Of Revocation Action, LIC 989A (3/17) - Non-Confidential Records Request Form, LIC 995 (9/08) - Child Care Center - Notification Of Parents' Rights, LIC 995A (8/08) - Family Child Care Home - Notification Of Parents' Rights, LIC 995B (8/08) - Family Child Care Home Addendum To Notification Of Parents' Rights (Regarding Removal/Exclusion), LIC 995C (8/08) - Family Child Care Home Addendum To Notification Of Parents' Rights (Regarding Reinstatement), LIC 995D (5/03) - Family Child Care Home Explanation Of Removal/Exclusions And Reinstatement, LIC 995E (10/09) - Important Information For Parents, LIC 995F (10/09) - Caregiver Background Check Information, LIC 996 (5/99) - Agreement For Licensure Of Community Care Facility/Child Care Facility On Federal Property, LIC 996A (5/01) - Agreement For Licensure Of Community Care Facility/Child Care Facility On Indian Reservations, LIC 997 (10/99) - Agreement By Licensee/Applicant On Federal Property, LIC 997A (4/01) - Agreement By Licensee/Applicant On Indian Reservations, LIC 999 (3/99) - Facility Sketch (Floor Plan), LIC 999A (2/05) - Facility Sketch (Floor Plan) - Family Child Care Home, LIC 9011A (4/05) - County Licensing Administrative Action Personnel Flagging Attachment, LIC 9011B (5/05) - CDSS Licensing Administrative Action Personnel Flagging Attachment, LIC 9020 (5/17) - Register Of Facility Clients/Residents, LIC 9020A (6/17) - Register Of Facility Residents - Residential Care Facilities For The Elderly, LIC 9029B (7/09) - Statement Of Facts Preparation Checklist, LIC 9031 (11/99) - Notice Of Temporary Suspension Order Of License, LIC 9040 (10/05) - Child Care Facility Roster, LIC 9054 (3/99) - Local Fire Inspection Authority Information, LIC 9058 (3/22) - Applicant/Licensee Rights, LIC 9059 (5/99) - Personal Property Procedures, LIC 9060 (2/00) - Resident Theft And Loss Record, LIC 9092 (2/11) - Fire Pre-Inspection/Consultation Request, LIC 9095 (6/99) - Evaluation Of Teacher Qualifications, LIC 9096 (2/00) - Evaluation Of Director Qualifications, LIC 9099 (12/16) - Complaint Investigation Report, LIC 9102TA (2/19) - Advisory Notes - Technical Assistance, LIC 9102TV (2/19) - Advisory Notes - Technical Violation, LIC 9106 (11/19) - Group Home Program Statement General Instructions, LIC 9106A (3/21) - Short-Term Residential Therapeutic Program, LIC 9108 (3/05) - Statement Acknowledging Requirement To Report Suspected Child Abuse, LIC 9111 (12/99) - Noncompliance Conference Summary, LIC 9112 (9/21) - Facility Compliance Plan, LIC 9118 (6/21) - Facility Inspection Checklist Checklist Child Care Centers, LIC 9119 (10/22) Facility Inspection Checklist Group Homes, LIC 9119 AA (7/22) - Facility Inspection Checklist Adoption Agency, LIC 9119 CCH (11/22) - Facility Inspection Checklist Community Crisis Home, LIC 9119 CN (8/22) - Facility Inspection Checklist Crisis Nurseries, LIC 9119 CTF (1/22) Facility Inspection Checklist Community Treatment Facility, LIC 9119 EBSH (4/22) - Facility Inspection Checklist Enhanced Behavioral Supports Homes, LIC 9119 TrSCF (12/22) - Facility Inspection Checklist Transitional Shelter Care Facility, LIC 9119 YHPC (4/22) - Facility Inspection Checklist Youth Homelessness Prevention Center, LIC 9120A (2/20) - Licensed Facility Inspection Checklist Adult Care Facilities, LIC 9121 (7/21) - Facility Visit Checklist Family Child Care, LIC 9122 (11/03) - Facility Visit Checklist Foster Family Home, LIC 9122A (7/20) Facility Inspection Checklist Small Family Home, LIC 9123 (2/20) - FacilityInspection Checklist - Residential Care Facility For The Elderly, LIC 9128 (5/23) - Foster Family Agency Program Statement, LIC 9139 (3/23) - Renewal Of Continuing Education Course Approval - Administrator Certification Program, LIC 9140 (5/23) - Request For Course Approval - Administrator Certification Program, LIC 9140A (3/23) - Request to Add or Replace Instructor, LIC 9141 (6/23) - Vendor Application/Renewal - Administrator Certification Program, LIC 9142A (3/23) - Roster of Participants, LIC 9148 (9/00) - Earthquake Preparedness Checklist (EPC), LIC 9149 (8/14) - Family Child Care Home Property Owner/Landlord Consent Form, LIC 9150 (8/14) - Parent Notification - Additional Children in Care, LIC 9151 (8/14) - Property Owner/Landlord Notification Family Child Care Home, LIC 9158 (7/22) - Telecommunications Device Notification, LIC 9163 (3/23) - Request Live Scan Service - Community Care Licensing, LIC 9163B (11/22) - Request Live Scan Service - Long Term Care OMBUDSMAN, LIC 9165 (4/22) - Board Of Director Statement, LIC 9166 (2/01) - Nebulizer Care Consent/Verification (Child Care Facilities), LIC 9172 (8/01) - Functional Capability Assessment, LIC 9182 (3/23) - Criminal Background Clearance Transfer Request, LIC 9185 (8/08) - Foster Family Agency Certified Home, LIC 9187 (7/00) - Child Care Client Death Report, LIC 9188 (3/23) - Criminal Record Exemption Transfer Request, LIC 9198 (7/01) - Modified Comprehensive Visit Licensee Self-Assessment Staff Qualifications/Records Module Child Care Centers, LIC 9199 (7/01) - Modified Comprehensive Visit Licensee Self-Assessment Children's Records Module Child Care Centers, LIC 9200 (9/11) - Pre-Licensing Facility Evaluation Checklist, LIC 9201 (10/01) - Annual Regulation Compliance Checklist, LIC 9210 (5/06) - Quarterly County Exemption Report, LIC 9211 (9/21) - Request For Inactive Child Care License Status, LIC 9212 (10/05) - Consumer Awareness Information - Family Child Care, LIC 9213 (1/04) - Notice Of Site Visit By A Child Care Licensing Office Representative, LIC 9214 (5/23) - Application for Administration Certification - Administrator Certification Program, LIC 9216 (3/17) - Complaint And Type A Violation Log, LIC 9217 (5/22) - Pre-Licensing Readiness Guide - Family Child Care Home, LIC 9219 (3/16) - Crisis Nursery Monthly Report, LIC 9219A (3/16) - Crisis Day Care Sign-In, LIC 9221 (5/22) - Parent Consent For Administration Of Medications And Medication Chart, LIC 9222 (9/05) - Blood Glucose Testing Consent/Verification Child Care Facilities, LIC 9223 (4/17) - Child Care Advocate Program, LIC 9224 (8/08) - Acknowledgement Of Receipt Of Licensing Reports, LIC 9225 (4/10) - Pre-Placement Questionnaire, LIC 9226 (5/18) - Request For Training Approval: Mandated Child Abuse Reporter Training, LIC 9227 (8/20) - Individual Infant Sleeping Plan, LIC 9229 (7/21) - Licensing Program Manager (LPM) Checklist For Complaint Review, LIC 9230 (7/21) - Licensing Program Analyst (LPA) Checklist For Complaint Review, LIC 9233 (7/20) Facility Inspection Checklist Foster Family Agencies, LIC 9234 (5/23) Entrance Checklist Foster Family Agency, LIC 9235 (10/22) Facility Inspection Checklist Short Term Residential Therapeutic Program, LIC 9236 (6/23) Entrance Checklist Short Term Residential Therapeutic Program, LIC 9237 (7/20) Facility Inspection Checklist Transitional Housing Placement Program, LIC 9238 (5/23) Entrance Checklist Transitional Housing Placement Program, LIC 9239 (5/23) Entrance Checklist Group Home, LIC 9239 AA (12/22) Entrance Checklist Adoption Agency, LIC 9239 CCH (3/23) - Entrance Checklist - Community Crisis Homes, LIC 9239 CN (3/23) - Entrance Checklist - Crisis Nurseries, LIC 9239 CTF (3/23) - Entrance Checklist Community Treatment Facility, LIC 9239 EBSH (3/23) - Entrance Checklist - Enhanced Behavioral Supports Homes, LIC 9239 TrSCF (3/23) - Entrance Checklist - Transitional Shelter Care Facility, LIC 9239 YHPC (3/23) - Entrance Checklist - Youth Homelessness Prevention Center, LIC 9240 (6/23) Entrance Checklist Small Family Home, LIC 9241 (2/20) - Entrance Checklist Adult Care Facilities, LIC 9242 (9/19) - Entrance Checklist Residential Care Facilities For The Elderly, LIC 9263 (3/21) Form 1-1: Resident Population, LIC 9264 (3/21) Form 1-2: Annual Provider Fee, LIC 9265 (6/21) Form 5-1: Long-Term Debt Incurred In A Prior Year (Including Balloon Debt), LIC 9266 (3/21) Form 5-2: Long-Term Debt Incurred During Fiscal Year (Including Balloon Debt), LIC 9267 (3/21) Form 5-3: Calculation Of Long-Term Debt Reserve Amount, LIC 9268 (6/21) Form 5-4: Calculation Of Net Operating Expenses, LIC 9269 (3/21) Form 5-5: Annual Reserve Certification, LIC 9270 (9/22) Form 7-1: Report On CCRC Monthly Care Fees, LIC 9271 (6/21) Form 9-1: Calculation Of Refund Reserve Amount, LIC 9272 (11/21) Annual Report Checklist, LIC 9273 (7/23) Continuing Care Retirement Community Disclosure Statement, LIC 9275 (6/21) - External Water Sampler Self-Certification Form, LIC 9276 (7/21) Child Care Center Sampling Checklist Form, IC 9277LUA (8/21) - Guardian Licensee User Access Form, LIC 9279 (10/21) - Pre-licensing Entrance Checklist - Child Care Centers, LIC 9280 (10/21) - Pre-licensing Entrance Checklist - Family Child Care Homes, LIC 9282 (6/23) Residential Infection Control Plan - Adult Residential Facilities, Enhanced Behavioral Supports Homes, Community Crisis Homes, Residential Care Facilities for the Elderly, Residential Care Facilities for the Chronically Ill, and Social Rehabilitation Facilities, LIC 9283 (6/23) - Infection Control Plan - Adult Day Programs.

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