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This version of the form is not currently in use and is provided for reference only. Download this version of
Form CCP4
for the current year.
Form CCP4 Health and Safety Self-certification (For License-Exempt Providers) - California
What Is Form CCP4?
This is a legal form that was released by the California Department of Social Services - a government authority operating within California. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is the CCP4 Health and Safety Self-certification?
A: The CCP4 Health and Safety Self-certification is a form required for License-Exempt Providers in California.
Q: Who needs to complete the CCP4 Health and Safety Self-certification?
A: License-Exempt Providers in California need to complete the CCP4 Health and Safety Self-certification.
Q: What is the purpose of the CCP4 Health and Safety Self-certification?
A: The purpose of the CCP4 Health and Safety Self-certification is to ensure that License-Exempt Providers comply with health and safety regulations.
Q: What information do I need to provide on the CCP4 Health and Safety Self-certification?
A: You will need to provide information about your facility, staff, and compliance with health and safety regulations on the CCP4 Health and Safety Self-certification.
Q: Is there a deadline for completing the CCP4 Health and Safety Self-certification?
A: Yes, License-Exempt Providers in California must complete the CCP4 Health and Safety Self-certification annually by a specified deadline.
Q: What happens if I do not complete the CCP4 Health and Safety Self-certification?
A: Failure to complete the CCP4 Health and Safety Self-certification may result in penalties or the suspension of your license-exempt status.
Q: Are there any fees associated with the CCP4 Health and Safety Self-certification?
A: No, there are no fees associated with the CCP4 Health and Safety Self-certification for License-Exempt Providers in California.
Form Details:
- Released on October 1, 2014;
- The latest edition provided by the California Department of Social Services;
- Easy to use and ready to print;
- Quick to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a fillable version of Form CCP4 by clicking the link below or browse more documents and templates provided by the California Department of Social Services.
Download Form CCP4 Health and Safety Self-certification (For License-Exempt Providers) - California
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