Enrollment and Other forms

Identification And Emergency Information

LIC 700 (8.08)

Child's Preadmission Health History - Parent's Report

LIC 702 (8.08)

Child Care Center - Notification Of Parents' Rights

LIC 995 (9.08)

Consent For Emergency Medical Treatment

LIC 627 (9.08)

Note:

There are other required forms that are needed for enrollment. These forms are available at our school as they are updated often.
Should you have any questions, please feel free to reach out to us and we’d be happy to help.

Other Forms

Nebulizer Care Consent Verification LIC 9166 (2.01)

This form is a state licensing requirement only if your child requires Nebulizer Care while in our care. If so, we also require a specific written instruction from the child’s physician annually that contains all of the following information:

Specific indications for administering the medication pursuant to the physician’s prescription.
Potential side effects and expected response.
Dose-form and amount to be administered pursuant to the physician’s prescription.
Actions to be taken in the event of side effects or incomplete treatment response pursuant to the physician’s prescription.
Instructions for proper storage of the medication.
The telephone number and address of the child’s physician.
These instructions shall be updated annually.

AB 2370 Lead Bill Flyer CCLPO2

Health and Safety Code requires all licensed child care centers to provide parents and guardians of enrolled children with written information on the risks and effects of lead exposure, blood lead testing requirements and recommendations, and options for locations of affordable blood lead tests as specified.