Get the free LIC 995 - California Department of Social Services - CA.gov - allegrawebsites

STATE OF CALIFORNIA HEALTH AND HUMAN SERVICES AGENCY CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION NOTIFICATION N SORE LOS DIRECTOR DE LOS PADRES EN REL ACI N A LAS GUARDER

How to fill out lic 995 - california

1. The LIC 995 form is required to be filled out by individuals or organizations that operate a nursery, pre-school, or child care center in the state of California. This includes both licensed and license-exempt child care providers.
2. To begin filling out the LIC 995 form, you will need to provide basic information about your child care facility, such as the name, address, and contact details.
3. The form also requires you to provide information about the facility's administration, including the name and contact information of the director or owner.
4. Next, you will need to provide details about the types of child care services offered at your facility, such as full-day care, part-day care, or before and after school care.
5. The LIC 995 form also asks for information about the maximum number of children your facility can accommodate and the age range of the children served.
6. Additionally, you will need to provide information about any subsidies or financial assistance programs offered at your facility, if applicable.
7. The form includes a section where you will need to disclose any criminal convictions or pending charges for the owner, director, or employees of the facility. This is important for ensuring the safety and well-being of the children in your care.
8. Finally, you will need to sign and date the form, certifying that the information provided is accurate and complete.

It's important to note that the LIC 995 form may require additional information depending on the specific requirements of your child care facility and the regulations set by the California Department of Social Services. It is recommended to thoroughly review the form and any accompanying instructions before filling it out.

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