CA LIC 279 2009-2025 free printable template

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Applicant s Signatures City and County where Signed Date Did you remember to Sign and date all documents in ink and enclose the application/licensing fee LIC 279 2/09 PAGE 1 OF 2 Need Help Completing The Application For a Family Child Care Home License These are instructions for filling out the Application for a Family Child Care Home License LIC 279. STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING APPLICATION FOR A FAMILY...CHILD CARE HOME LICENSE AGENCY USE ONLY Type or print clearly. NUMBER TYPE TYPE OF APPLICATION New Application Capacity Change APPLICANT S First Location Change ASSIGN Update Middle Last Name Over 18 Years Old CITY COUNTY STATE ZIP 3b. IF YOU HAVE NOT LIVED IN THIS COUNTY FOR THE PAST TWO YEARS LIST THE COUNTIES IN WHICH YOU HAVE RESIDED 4. MAILING ADDRESS if different No Yes EMAIL ADDRESS NOT REQUIRED DIRECTION S TO HOME DATE LICENSED/CERTIFIED Pending PHONE ADDRESS TYPE OF LICENSE LICENSING...AGENCY LICENSE OTHER ADULTS IN THE HOME Not applicant s Do not list the names of persons under 18 years of age First Name 6. ARE YOU CURRENTLY OR HAVE YOU EVER BEEN LICENSED OR CERTIFIED FOR ANY TYPE OF FACILITY TO CARE FOR CHILDREN OR ADULTS YOUR HOME ADDRESS 3a* CURRENT CHILDREN IN YOUR HOME LIC 279B Click to access Small Home up to 8 Large Home up to 14 AGES TO BE SERVED Relationship to You DAYS HOURS OPEN 10. APPLICANT/LICENSEE RESPONSIBILITY - I/We certify that A. B. C. D. E* F* G* I/We...live in the home to be licensed* I/We have money to maintain the level of service required by law in a Family Child Care Home. I/We have both a State Fire Marshal approved fire extinguisher rated 2A 10B C and a smoke detector in operating condition* I/We shall stay current and in compliance with the laws and regulations governing standards for Family Child Care Homes. I/We shall obtain approval from the licensing agency before making changes in our license capacity or to our home. I/We shall...notify the licensing agency when we want to discontinue our license. I/We have informed the property owner if leased or rented that we will be operating a Family Child Care Home on the premises. The owner/landlord has been sent the Property Owner/Landlord Notification LIC 9151. H. I/We have written consent from the property owner if leased or rented when I plan to expand my Small Family Child Care Home capacity from 6 to 8 children or to expand my Large Family Child Care Home capacity from 12 to...14 children* Property Owner/Landlord Consent Form LIC 9149. I. I/We understand the requirements to report known or suspected child abuse LIC 9108. 11. PERJURY STATEMENT - I/We declare under penalty of perjury that the statements on this application and accompanying attachments are correct to the best of my/our knowledge. Match the numbered items on this page with the numbered sections on the Application* For your information details on the Application are public information* are not now...licensed* A Capacity Change is a request to increase the approved number of children in an already licensed home.

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Essential Guide to the CA -2025 Form

Overview of the CA -2025 Form

The CA LIC 279 form is a critical document used for applying for a family child care home license in California. This form facilitates the licensing process for individuals who wish to provide child care services in their homes, ensuring compliance with state regulations. The 2 version encompasses updated requirements and standards that align with current laws.

Key Features of the CA 279 Form

The CA LIC 279 form includes several essential features that support applicants in complying with licensing requirements. It captures vital information about the applicant, including personal details, the address of the child care facility, and specific capacities and services offered. Furthermore, the form emphasizes the importance of safety inspections and fire safety compliance.

Required Information for Submission

To complete the CA LIC 279 form, applicants must provide comprehensive information regarding their personal background, including employment history, residency details, and any prior child care experience. Additionally, they must include details about the physical environment where child care will be provided, outlining safety measures and operational hours.

Best Practices for Completing the CA 279 Form

It is advisable for applicants to follow best practices when filling out the CA LIC 279 form. These include carefully reading each instruction, ensuring clarity and accuracy in responses, and double-checking all provided information for consistency. Moreover, utilizing a typed format can improve legibility and streamline the review process.

Common Errors to Avoid

Several common errors can impede the successful submission of the CA LIC 279 form. These include omitting required fields, providing inaccurate or outdated information, and failing to sign and date the form. By being aware of these pitfalls, applicants can enhance their chances of timely processing and approval.

Submission Methods for the CA 279 Form

Once completed, the CA LIC 279 form must be submitted to the appropriate licensing agency. Applicants can typically choose between submitting the form by mail or electronically, depending on the specific requirements of their local jurisdiction. It is important to verify submission guidelines to ensure compliance with state regulations.

Who Should Use the CA 279 Form

The CA LIC 279 form is intended for individuals seeking to operate a family child care home in California. This includes prospective caregivers who meet the necessary qualifications and are committed to providing safe, regulated childcare services in their homes.

Frequently Asked Questions about form lic 279

What is the purpose of the CA LIC 279 form?

The CA LIC 279 form is used to apply for a family child care home license in California, ensuring that providers meet state safety and compliance standards.

How can I prevent common errors when filling out the CA LIC 279 form?

To avoid errors, carefully follow the instructions, ensure all information is accurate and complete, and review the form for omissions before submission.