Social Security

Form LIC 126 is an entrance checklist specifically designed for Family Child Care Homes in California. Its main purpose is to assess and document the compliance of a family child care home with the licensing regulations prior to admission.

The form consists of sections to evaluate various aspects of the child care home, including safety measures, physical environment, equipment, furnishings, and emergency procedures. It serves as a guide to ensure that the child care home meets the necessary standards for licensing.

Form LIC 05A is a resource family approval certificate used in California. Its main purpose is to officially certify the approval of a resource family to provide foster care services.

The form consists of sections where the licensing agency provides details such as the name of the approved resource family, the date of approval, and the names and signatures of the agency representatives involved in the approval process.

Form LIC 03 is a document for agency use only in California. Its purpose is to provide an assessment checklist for evaluating the health and safety of a resource family home during the approval process.

This form is typically completed by a licensing agency representative or social worker who conducts an inspection of the resource family home. It includes sections to assess various aspects of the home, such as living conditions, safety measures, cleanliness, and the presence of any potential hazards.

This form, Form LIC 01C, is a confidential resource family application used in California. Its main purpose is to collect personal and sensitive information about the applicant and their household members for the evaluation and approval process.

The form consists of sections where the applicant provides personal details such as name, address, contact information, and date of birth. It also includes sections to document the background and criminal history information of all adult household members.

Form LIC 01A is an application form used in California for individuals interested in becoming a resource family. The purpose of this form is to initiate the application process and gather essential information about the prospective resource family.

The form consists of sections where the applicant provides personal information such as name, address, contact details, and background information. There are fields to document the applicant's household composition, including information about all adult members residing in the home.

Form LIC 00A is an application form specifically designed for individuals who want to convert their existing foster care license or approval to become a resource family in California. The purpose of this form is to gather detailed information about the applicant and their suitability to serve as a resource family.

Form LIC 00 is used in California for the conversion to a resource family. It serves as a release of information, authorizing the exchange of relevant information between the applicant and the licensing agency. The main purpose of this form is to grant permission for the sharing of information necessary for the evaluation and approval process.

The LIC 9227 form, Individual Infant Sleeping Plan, is a document used by child care providers in the state of California. It is designed to ensure the safety and well-being of infants in child care settings by outlining specific sleeping arrangements and practices.

The form consists of several sections that cover important aspects related to infant sleep. These sections include:

The LIC 9151 form, known as the "Property Owner/Landlord Notification Family Child Care Home," is a crucial document provided by the California Department of Social Services. This form serves a specific purpose related to the notification process for property owners or landlords when an individual intends to operate a family child care home on their premises.

The LIC 9217 form, known as the "Pre-Licensing Readiness Guide - Family Child Care Home," is an important document provided by the California Department of Social Services. This form serves a specific purpose related to individuals or entities interested in obtaining a license for operating a family child care home in California.