A brief description of the forms
- Lic 613A
- Lic 627
- Lic 700
- Lic 702
- Lic 9150
- Lic 9166
- Lic 9212
- Lic 995A
- Lic 995E
- Photo Release
- EMAIL YOUR FORMS
PERSONAL RIGHTS
CONSENT FOR EMERGENCY MEDICAL TREATMENTChild
Care Centers Or Family Child Care Homes
IDENTIFICATION AND EMERGENCY INFORMATION
CHILD CARE CENTERS/FAMILY CHILD CARE HOMES
To Be Completed by Parent or Authorized Representative
CHILD’S PREADMISSION HEALTH HISTORY—PARENT’S REPORT
PARENT NOTIFICATION
ADDITIONAL CHILDREN IN CARE
NEBULIZER CARE CONSENT/VERIFICATION
CHILD CARE FACILITIES
We only need this form if it applies to you
FAMILY CHILD CARE
CONSUMER AWARENESS INFORMATION
No need to turn this in. This is only for your information
FAMILY CHILD CARE HOME
NOTIFICATION OF PARENTS’ RIGHTS
CAREGIVER BACKGROUND CHECK PROCESS
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
I do not need this back. This is for your information only
This is allowing me to take photos of your child.
You can email your completed forms to EvaJaurigui@gmail.com or you can drop them off.