LPA Explained the following sample forms packet:
Children Records: LIC: 700 Identification And Emergency Information, LIC 995E Caregiver Background Check Process, LIC 995A Notification of Parent’s Rights, LIC 627 Consent For Emergency Medical Treatment, LIC 282 Affidavit Regarding Liability Insurance, LIC 9150 Parent Notification, Additional Children in Care. Copies given to applicant.
Facility Records: PUB 394 Notification of Parents Rights, LIC 9040 Facility Roster, LIC 624A Death Report, LIC 6101A Emergency Disaster Plan, LIC 9148 Earthquake Preparedness Checklist, LIC 624B Unusual Incident/Injury Report, and Fire/ Disaster Drill (copy given).
Staff Records: LIC 508 Criminal Record Statement, LIC 9052 Employee Rights, LIC 9108 Statement Acknowledging Requirement to Report Child Abuse, LIC 9163 Request for LIVESCAN, LIC 9188 Criminal Record Exemption Transfer Request, LIC 9182 Criminal Background Clearance Transfer Request. Required Immunization's, TB test.
LPA received copies of LIC 508. Copy of family child care home ratio for large family child care homes given to applicant.
Web address for downloading forms or regulations was provided as http://ccld.ca.gov/PG411.htm.
Fire Clearance was received and approved for requested capacity.
The home was not incompliance with Title 22 Regulations. The following corrections will need to be submitted to the licensing office within 30 days. LPA informed applicant that a final review of the file, will be done before the license is issued. The applicant will be notified if any corrections or additions still need to be completed.
* Current EMSA certified CPR & First Aid * Air conditioning in backyard unit accessible to children.
Report was reviewed and discussed. Exit interview conducted with applicant and appeal rights procedure explained.