Form LIC 9052, Notice Employee Rights , is a legal document that informs every new employee of a child care facility of their rights to file complaints against the employer for violating laws and regulations.
This form was released by the California Department of Social Services (CDSS) , a component of the California Health and Human Services Agency (CHHS). The latest version of the form was issued on January 1, 2022 , with all previous editions obsolete. You can download a fillable LIC 9052 Form through the link below.
Form LIC 9052 (SP), Notificacion Derechos del Empleado (a Spanish version of the LIC 9052) can also be found on our website.
Form LIC 9052 notifies an employee about their protection from demotion, suspension, discharge, or the threat thereof for the following actions:
If an employee believes their employer has unlawfully demoted, suspended, discharged them, or threatened to do any of the above, it is necessary to do the following:
The LIC Notice of Employee Rights is signed before an employee starts work. The employee must sign this form, identify the employer, name the facility, and write down the actual date of signing. Then, the bottom of the form that contains the signature is detached and kept in the employee's personnel file, while the employee receives instructions forpersonal use. If an employee refuses to sign the notice, prepare a dated notation to that effect and retain it with the employee's personnel record.