Responsible person or placement agency 3. 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 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 Physician's checklist (child care facilities) Web lic 700 (8/08)(confidential) title:
Additional persons who may be called in an emergency. Web lic 700 (eng/sp) (5/00)(confidential) created date: Web tus niam txiv/neeg saib xyuas lossis tus muaj cai sawv cev kos npe hnub tim. Receive, from the licensee, the caregiver background check process form.
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. Signature of person completing form. California department of social services community care licensing division.
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California department of social services community care licensing division. California department of social services community care licensing division. Web lic 700 (10/19) (confidential) page 2 of 2 names of persons authorized to take child from.
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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.
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California department of social services. 3825, 3510 and neft combined for matuirty claim 3825 discharge form maturity claim 5180. Responsible person or placement agency. Web lic 700 (10/19) (confidential) page 2 of 2 names of.
Name of client or child 2. To be completed by parent or authorized representative. State of california health and human services agency. Identification and emergency information child care centers/family child care homes. Form lic700 is often used in family child care home, child care center, california department of social services.
Identification and emergency information child care centers/family child care homes. Form lic700 is often used in family child care home, child care center, california department of social services. Web lic 700 (eng/sp) (5/00)(confidential) created date:
Name Of Client Or Child 2.
Identification and emergency information child care centers created date: 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 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.
Identification And Emergency Information Child Care Centers/Family Child Care Homes.
To be completed by parent. Web lic 700 (eng/sp) (5/00)(confidential) created date: 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 California department of social services community care licensing division.
Additional Persons Who May Be Called In An Emergency.
Ca dept of social services subject: 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 State of california health and human services agency. Web tus niam txiv/neeg saib xyuas lossis tus muaj cai sawv cev kos npe hnub tim.
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.
Web lic 700 (9/07)(confidential) title: California department of social services. California department of social services community care licensing division. Signature of person completing form.
Be informed, by the licensee, that the facility has or does not have liability insurance (or a bond) that 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. 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 Web tus niam txiv/neeg saib xyuas lossis tus muaj cai sawv cev kos npe hnub tim. Identification and emergency information child care centers/family child care homes.