Form LIC 9239 CN. Entrance Checklist - Crisis Nurseries - California

Form LIC 9239 CN is used in California by crisis nurseries to document and track the process of admitting a child or children into their facility. This form is completed by crisis nursery personnel when accepting a child for temporary care during times of family crisis or emergency.

The form consists of sections that require information about the child being admitted, including personal details, emergency contact information, medical history, and any specific needs or considerations. Important fields include the child's name, date of birth, guardian information, allergies, and any behavioral or health concerns. Accurate completion of this form ensures that relevant information is gathered to provide appropriate care and support to the child while in the crisis nursery.

An application example of this form would involve a crisis nursery using Form LIC 9239 CN when admitting a child into their facility. Crisis nursery personnel would gather the necessary information, conduct a brief assessment of the child's needs, and ensure that any immediate safety concerns are addressed. By completing this form, crisis nurseries can maintain accurate records and provide temporary care for children in crisis situations.

Alternative forms: An alternative form to consider is the Form LIC 9213, Request for Placement of a Child With a Residential Foster Family - California. While Form LIC 9239 CN focuses on entrance information for crisis nurseries, Form LIC 9213 is used to request placement of a child with a residential foster family. The main difference lies in the type of care provided, with crisis nurseries offering short-term temporary care during emergencies or family crises, and residential foster families providing longer-term foster care placements for children in need of stable living arrangements.