California Department of Social Services Forms

This Form is used for planning group activities in the state of California.

This form is mandatory for any facilities that handle incoming cash resources to maintain an accurate record of all sums received and distributed.

This form is used for recording and tracking cash transactions for clients and residents in California.

This document is filled out when an individual is admitted to a facility to establish all of the necessary details about the resident and a contact person that may be reached if the resident gets involved in an emergency situation.

This form is used for California family child care home providers to notify parents about their rights regarding reinstatement. It is an addendum to the notification form LIC996 and provides additional information.

This Form is used for providing budget information in the state of California.

This form is used for explaining the reasons for removal or exclusion of a family child care home in California, as well as the process for reinstatement.

This Form is used for providing important information to parents in California. It includes details about child care programs and services, as well as health and safety guidelines.

This form is used for conducting background checks on caregivers in California. It collects information necessary for screening individuals who provide care to vulnerable populations.

This Form is used for reporting civil penalties that are due in the state of California.

This form is used for obtaining a license to operate a community care facility or child care facility on federal property in California.

This form is used for documenting civil penalties in California. It serves as a ledger to record information related to penalties imposed in various civil cases.

This form is used for agreeing to license a community care facility or child care facility on Indian reservations in California.

This form is used for recording a client's cash resources when there is a change of licensee in California.

This Form is used for notifying the California Department of Insurance about an incomplete application for licensure.

This form is used for applicants or licensees in California who are entering into an agreement for the use of federal property.

This is form issued by the California Department of Social Services (CDSS). It is filed to keep a current list of the staff (including backup persons, volunteers, etc.) employed and residing on the facility.

This form is used for creating an agreement between a licensee or applicant and Indian Reservations in California.

This Form is used for notifying the incomplete foster family home application in California.

This form is used for submitting a facility sketch or floor plan in California as part of the licensing process.

This document is completed by every community care employee to provide an employer with information concerning the employee's personal details and employment experience.

This form is used for notifying the initial denial of an application in the state of California.

This Form is used for creating a facility sketch or floor plan for a Family Child Care Home in California. It helps in ensuring compliance with regulations and permits.

This form is used for attending an orientation meeting for a family child care home in California.

This document is an attachment to the LIC9011A form used for County Licensing Administrative Action Personnel Flagging in California. It contains additional information and requirements related to personnel flagging.

This form is used for providing additional information and documentation related to administrative actions and personnel flagging in the licensing process in California.

This form is used for transmitting legal cases in the state of California. It is used to provide information about the case and to request action from the appropriate authorities.

This Form is used for requesting a review of any deficiencies or penalties imposed by the California Department of Insurance.

This form is used for individuals in California to provide a statement about their criminal record history for certain licensing applications or employment purposes. It allows individuals to disclose any prior convictions or arrests in order to comply with state regulations and ensure transparency.

This is a document signed by a child's parent, guardian, or representative in order to acknowledge that a child's personal rights are observed and respected while the child is receiving services from a child care center.

This form is used for asserting personal rights in adult community care facilities in the state of California.

This form is used for preparing a Statement of Facts in California. It serves as a checklist to ensure all necessary information is included in the statement.

This form is used for providing notice in the state of California.

This form must be kept by all child care centers, infant care centers, and family child care homes and be made available to the licensing agency upon request.