Form Lic 995a - Family Child Care Home Notification Of Parents' Rights
Download a blank fillable Form Lic 995a - Family Child Care Home Notification Of Parents' Rights in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Form Lic 995a - Family Child Care Home Notification Of Parents' Rights with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1STATE OF CALIFORNIA—HEALTH AND HUMAN SERVICES AGENCY
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FAMILY CHILD CARE HOME
NOTIFICATION OF PARENTS’ RIGHTS
PARENTS’ RIGHTS
As a Parent/Authorized Representative, you have the right to:
1.
Enter and inspect the family child care home without advance notice whenever children are in care.
2.
File a complaint against the licensee with the licensing office and review the licensee’s public file
kept by the licensing office.
3.
Review, at the family child care home, reports of licensing visits and substantiated complaints
against the licensee made during the last three years.
4.
Complain to the licensing office and inspect the family child care home without discrimination or
retaliation against you or your child.
5.
Be notified and receive, from the licensee, a written notice that lists the name of any person not
allowed in the family child care home while children are present. (NOTE: This notice is only
required when the Department has, in writing, excluded someone from the family child care
home on or after January 1, 2001).
6.
Request in writing that a parent not be allowed to visit your child or take your child from the family
child care home, provided you have shown a certified copy of a court order.
7.
Receive from the licensee the name, address and telephone number of the local licensing office.
Licensing Office Name:
_________________________________________________
Licensing Office Address:
_________________________________________________
Licensing Office Telephone #:
_________________________________________________
8.
Be informed by the licensee, upon request, of the name and type of association to the family child
care home for any adult who has been granted a criminal record exemption, and that the name of
the person may also be obtained by contacting the local licensing office.
9.
Receive, from the licensee, the Caregiver Background Check Process form.
10.
Be informed, by the licensee, that the facility has or does not have liability insurance (or a bond) that
covers injury to clients due to the negligence of the licensee or employees of the facility.
NOTE: CALIFORNIA STATE LAW PROVIDES THAT THE LICENSEE MAY DENY ACCESS TO THE FAMILY CHILD
CARE HOME TO A PARENT/AUTHORIZED REPRESENTATIVE IF THE BEHAVIOR OF THE
PARENT/AUTHORIZED REPRESENTATIVE POSES A RISK TO CHILDREN IN CARE.
For the Department of Justice “Registered Sex Offender”database, go to
(Detach Here - Give Upper Portion to Parents))
LIC 995A (8/08)
A C K N O W L E D G E M E N T O F N O T I F I C AT I O N O F PA R E N T S ’ R I G H T S
(Parent/Authorized Representative Signature Required)
I, the parent/authorized representative of_______________________________, have received a copy of the “FAMILY
CHILD CARE HOME NOTIFICATION OF PARENTS’ RIGHTS”, the CAREGIVER BACKGROUND CHECK PROCESS
and the FAMILY CHILD CARE CONSUMER AWARENESS INFORMATION form from the
licensee._____________________________________________
Name of Family Child Care Home
Signature (Parent/Authorized Representative) ______________________________________________________________Date____________________
the
NOTE: This Acknowledgement must be kept in child’s file and a copy of the Notification given to
parent/authorized representative.
For the Department of Justice “Registered Sex Offender”database, go to
LIC 995A (8/08)
ADVERTISEMENT
0 votes
Related Articles
Related forms
Family Child Care Home Addendum To Notification Of Parents' Rights (regarding Removal/exclusion) State Of California - Health And Human Services Agency
Legal
![Parental Consent To [foster Care, Adoption, Termination Of Parental Rights] Of An Indian Child](https://data.formsbank.com/pdf_docs_html/291/2913/291319/page_1_thumb.png "Parental Consent To [foster Care, Adoption, Termination Of Parental Rights] Of An Indian Child")
Parental Consent To [foster Care, Adoption, Termination Of Parental Rights] Of An Indian Child
Legal
Related Categories
Parent category: Legal