Form LIC 627. Consent For Emergency Medical Treatment - Child Care Centers Or Family Child Care Homes
The LIC 627 form, also known as the "Consent for Emergency Medical Treatment - Child Care Centers or Family Child Care Homes," is a crucial document regulated by the California Department of Social Services, Community Care Licensing. This form plays a significant role in ensuring the safety and well-being of children in childcare settings.
The main purpose of the LIC 627 form is to obtain consent from parents or legal guardians for emergency medical treatment that may be necessary while their child is under the care of a licensed child care center or family child care home. It serves as a legally binding agreement between the child care provider and the parent/guardian, outlining the conditions under which emergency medical treatment may be administered.
The LIC 627 form consists of several important fields that must be completed accurately. These typically include:
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Child's Information: The child's full name, date of birth, and any known allergies or pre-existing medical conditions that need to be considered during emergencies.
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Parent/Guardian Information: The name, contact details, and signature of the parent or legal guardian granting consent for emergency medical treatment.
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Authorized Individuals: Any individuals authorized by the parent/guardian to consent to emergency medical treatment on their behalf when they cannot be reached immediately.
When filling out the form, it is vital to ensure that all information provided is up-to-date and accurate. The parent/guardian must sign the form to indicate their understanding and agreement to the terms outlined within it. In some cases, additional documents, such as medical authorization forms or copies of health insurance cards, may need to be attached to the LIC 627 form to support the child's medical needs during emergencies.
Examples of application scenarios where the LIC 627 form would be required include situations where a child sustains an injury, develops a sudden illness, or requires immediate medical attention while under the care of a licensed child care center or family child care home. The form allows caregivers to seek prompt medical treatment without delay, ensuring the child's health and well-being.
It is essential to note that there may be related or alternative forms used in different jurisdictions or settings. However, for child care facilities regulated by the California Department of Social Services, the LIC 627 form is the designated document for obtaining consent for emergency medical treatment.
Once completed, the LIC 627 form should be securely stored by the child care facility. It is crucial to maintain confidentiality and ensure easy accessibility in case of emergencies. The form may be submitted to the licensing agency during compliance inspections or requested by regulatory authorities for verification purposes.
In summary, the LIC 627 form is a vital document used in California child care centers and family child care homes to secure parental consent for emergency medical treatment. By accurately completing this form, child care providers can promptly address medical emergencies, safeguarding the welfare of children under their supervision.