Form LIC 421CC. Civil Penalty Assessment - Child Care - California

Form LIC 421CC is used in California to assess civil penalties related to child care services in licensed facilities or programs. The main purpose of this form is to document and enforce penalties for non-compliance with regulations pertaining to child care.

The form consists of sections where the Department of Social Services (DSS) assesses the civil penalties against the facility or program. This may include details such as the facility's name, location, nature of violations, applicable regulations, penalty amounts, and any additional information or documentation related to the case. The form may also provide spaces for the DSS representative's signature and date.

Important fields on this form include accurately documenting the violation details, ensuring adherence to the applicable regulations and guidelines regarding child care services, determining appropriate penalty amounts based on the severity and frequency of non-compliance, and providing clear explanations or evidence to support the assessment. It is crucial for the DSS representative to conduct a thorough investigation and follow established procedures when completing the form to ensure fair enforcement of penalties.

Application Example: A licensed child care center in California fails to maintain proper staff-to-child ratios, violating licensing regulations and compromising child safety. Form LIC 421CC would be used by the DSS to assess civil penalties against the facility. By completing the form, the DSS takes necessary actions to address non-compliance, protect children, and uphold standards for quality child care services.

Related Forms: There are no specific related forms mentioned for Form LIC 421CC. However, other forms related to child care regulation compliance and enforcement may be required for comprehensive oversight and penalty assessments.