Form Lic 281d - Application And Supporting Documentation Checklist - Foster Family Agency Page 2
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7CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY
COMMUNITY CARE LICENSING DIVISION
INTRODUCTION
These instructions are intended to help you file an application for a Foster Family Agency (FFA) license. The above checklist
guides an applicant in filing the application. Before a license can be issued, the licensing agency must review the Application
and Supporting Documentation submitted to verify you meet the minimum requirements for the license.
The initial application fee plus all Application and Supporting Documentation must be completed and sent to the licensing
agency as a packet. The application fee is non-refundable. Your application cannot be started until all the forms are filed
with the licensing agency. The FFA shall submit a copy of its program statement to all county placing agencies with which
placements are coordinated or services provided for, including the county in which the facility is located, for optional review
when the FFA updates its plan of operation/program statement. Once the letter of recommendation(s) has been received, the
initial application (LIC 200) must be filled out with the attached Letter of recommendation(s), and submitted to the licensing
agency for review.
Submit two complete copies of all Application and Supporting Documentation in the same sequence as they are listed above,
tabbed and in binders. If the forms are incomplete, the licensing agency will return the entire packet to you. To prevent delays,
be sure that you have all the necessary information completed, properly signed, with original signatures, and dated. Make a
photocopy of your Application and Supporting Documentation before you give it to the licensing agency.
CREDIT REPORT - The purpose of a consumer credit report is to report your credit history and whether or not you repay loans
on time for the things you buy.
Your rights of privacy are protected by law. The Department of Social Services obtains credit reports per Section 604 of the Fair
Credit Reporting Act:
“A consumer reporting agency may furnish a consumer report under the following circumstances
and no other :...(3) To a person which it has reason to believe… (D) intends to use the information
in connection with a determination of the consumer’s eligibility for a license or other benefit granted
by a governmental instrumentality required by law to consider an applicant’s financial responsibility
or status:…”
Your consumer credit report is maintained in the confidential section of your facility file which is maintained in your local
regional office.
REGULATIONS - The regulations that govern FFAs covered by these application instructions are under California Code
of Regulations, Title 22, Division 6 and interim licensing standards, Chapter 8.8 Foster Family Agencies, Articles 9,
and Subchapter1.
Copies of the regulations and amendments can be downloaded from
LIC 281D (1/17) (PUBLIC - OPTIONAL)
PAGE 2 OF 7
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