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Form lic700 is often used in family child care home, child care center, california department of social services. Name of client or child 2. State of california health and human services agency. Identification and emergency.

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Signature of person completing form. Web lic 700 (10/19) (confidential) page 2 of 2 names of persons authorized to take child from the facility (child will not be allowed to leave with any other person.

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State of california health and human services agency. Web lic 700 (10/19) (confidential) page 2 of 2 names of persons authorized to take child from the facility (child will not be allowed to leave with.

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State of california health and human services agency. Signature of person completing form. Name of client or child. Web lic 700 (eng/sp) (5/00)(confidential) created date: Receive, from the licensee, the caregiver background check process form.

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Identification and emergency information child care centers created date: Be informed, by the licensee, that the facility has or does not have liability insurance (or a bond) that Social security number (optional) date of birth.

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Form lic700 is often used in family child care home, child care center, california department of social services. Signature of person completing form. Web lic 700 (8/08)(confidential) title: California department of social services. Additional persons.

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Web lic 700 (8/08)(confidential) title: Identification and emergency information child care centers/family child care homes. Responsible person or placement agency. Web lic 700 (10/19) (confidential) page 2 of 2 names of persons authorized to take.

Web lic 700 (9/07)(confidential) title: State of california health and human services agency. State of california health and human services agency. Be informed, by the licensee, that the facility has or does not have liability insurance (or a bond) that Web lic 700 (eng/sp) (5/00)(confidential) created date:

State of california health and human services agency. Signature of person completing form. Identification and emergency information child care centers created date:

Name Of Client Or Child 2.

Identification and emergency information child care centers/family child care homes. To be completed by parent or authorized representative. California department of social services. Web lic 700 (10/19) (confidential) page 2 of 2 names of persons authorized to take child from the facility (child will not be allowed to leave with any other person without written authorization from parent or authorized representative) name relationship time child will be picked up signature of parent/guardian or authorized representative date

Name Of Client Or Child.

3825, 3510 and neft combined for matuirty claim 3825 discharge form maturity claim 5180. Signature of person completing form. All facilities [except child care center/family child care home completes lic 700] 1. California department of social services community care licensing division.

Web Lic 700 (9/07)(Confidential) Title:

Web lic 700 (10/19) (confidential) page 2 of 2 names of persons authorized to take child from the facility (child will not be allowed to leave with any other person without written authorization from parent or authorized representative) name relationship time child will be picked up signature of parent/guardian or authorized representative date Additional persons who may be called in an emergency. Receive, from the licensee, the caregiver background check process form. Social security number (optional) date of birth age sex 2.

State Of California Health And Human Services Agency.

California department of social services community care licensing division. Web lic 700 (eng/sp) (5/00)(confidential) created date: Physician's checklist (child care facilities) Web tus niam txiv/neeg saib xyuas lossis tus muaj cai sawv cev kos npe hnub tim.

Name of client or child. All facilities [except child care center/family child care home completes lic 700] person(s) responsible for financial affairs, payment for care, legal guardian, if any other persons to be notified in emergency emergency hospitalization plan other required information 1. California department of social services community care licensing division. State of california health and human services agency. All facilities [except child care center/family child care home completes lic 700] 1.