Provider Forms

Forms for Childs File

Pre-Admission Health Report (not required) 

Identification & Emergency Information

Notification of Parents Rights     

Addendum to Parents (Removal/Exclusion)

Addendum To Parents (Reinstatement).

FCC Explanation of Removal/Exclusion/Reinstate

Caregiver Background Check Process.

Caregiver Background Check Information

Consent For Medical Treatment.    

Parent Notification/Addit'l Children in care

Affidavit Regarding Liability Insurance.     

Consent/Verification for Nebulizer Care(only if needed)

Family Child Care What Are Parents' Responsibilities

California School Immunization Record (Blue Card)

Facility Forms/Records

Unusual Incident/Injury Report

Child Care Facility Roster

Statmnt Acknowledging Requirement to Report Suspected Child Abuse

Property Owner/Landlord Consent Form for addi'l children 8 or 12

Property Owner/Landlord Notification Form

CCL/Aplicant/Licensee Rights

Emergancy Disaster Plan

Facility Visit Check List

Forms Needed For Employees

Crimminal Record Statement

Notice Of Employee Rights

Request for Live Scan

Criminal Background Clearance Transfer Request

You can find out if prints have cleared by clicking here www.ccld.ca.gov and going to Background Clearance.

Information To Be Posted In Your
Family Child Care Home

Emergancy Disaster Plan

Notification of Parents Rights Poster

Notice of Site Visit

BAD CHECKS

Are you tired of receiving payment in the form of a check, only to find out weeks later that the check has been returned by the bank?  If so, there is something that you can do.  The District Attorney's Office has a program that you can use when parents refuse to pick up the checks.  You must first ask for payment in writing and wait 10 days for a response.  When they fail to pick up the check you can then turn it over to the District Attorney's Office for collection.  Not only will they have to pay the amount of the check but also your returned check fee and they will be required to take an 8 hour class.  Here is the link that will get you to the forms needed to complete this action:

District Attorney's Office