Form Lic 995 PDF Details

Form Lic 995 is an important form that should be completed when starting a new business in California. The form can be downloaded from the Secretary of State's website, and it is important to ensure that all required information is included on the form. Filing this form will help to ensure that your new business is registered with the state and that you are in compliance with any relevant laws.

You will find information regarding the type of form you wish to prepare in the table. It can show you the length of time you will need to complete form lic 995, exactly what fields you will need to fill in and several further specific details.

QuestionAnswer
Form NameForm Lic 995
Form Length1 pages
Fillable?Yes
Fillable fields7
Avg. time to fill out1 min 39 sec
Other nameslicensee, retaliation, LIC, Detach

Form Preview Example

STATE OF CALIFORNIA—HEALTH AND HUMAN SERVICES AGENCY

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES

 

COMMUNITY CARE LICENSING DIVISION

CHILD CARE CENTER

NOTIFICATION OF PARENTS’ RIGHTS

PARENTS’ RIGHTS

As a Parent/Authorized Representative, you have the right to:

1.Enter and inspect the child care center without advance notice whenever children are in care.

2.File a complaint against the licensee with the licensing office and review the licensee’s public file kept by the licensing office.

3.Review, at the child care center, reports of licensing visits and substantiated complaints against the licensee made during the last three years.

4.Complain to the licensing office and inspect the child care center without discrimination or retaliation against you or your child.

5.Request in writing that a parent not be allowed to visit your child or take your child from the child care center, provided you have shown a certified copy of a court order.

6.Receive from the licensee the name, address and telephone number of the local licensing office.

Licensing Office Name:

_________________________________________________

Licensing Office Address:

_________________________________________________

Licensing Office Telephone #:

_________________________________________________

7.Be informed by the licensee, upon request, of the name and type of association to the child care center for any adult who has been granted a criminal record exemption, and that the name of the person may also be obtained by contacting the local licensing office.

8.Receive, from the licensee, the Caregiver Background Check Process form.

NOTE: CALIFORNIA STATE LAW PROVIDES THAT THE LICENSEE MAY DENY ACCESS TO THE CHILD CARE CENTER TO A PARENT/AUTHORIZED REPRESENTATIVE IF THE BEHAVIOR OF THE PARENT/AUTHORIZED REPRESENTATIVE POSES A RISK TO CHILDREN IN CARE.

For the Department of Justice “Registered Sex Offender”database, go to www.meganslaw.ca.gov

LIC 995 (9/08)(Detach Here - Give Upper Portion to Parents)

AC K N OW L E D G E M E N T O F N OT I F I C AT I O N O F PA R E N T S ’ R I G H T S

(Parent/Authorized Representative Signature Required)

I, the parent/authorized representative of ________________________________________________, have

received a copy of the “CHILD CARE CENTER NOTIFICATION OF PARENTS’ RIGHTS” and the CAREGIVER BACKGROUND CHECK PROCESS form from the licensee.

_____________________________________

Name of Child Care Center

______________________________________________

__________________

Signature (Parent/Authorized Representative)

Date

NOTE: This Acknowledgement must be kept in child’s file and a copy of the Notification given to parent/authorized representative.

For the Department of Justice “Registered Sex Offender”database go to www.meganslaw.ca.gov

LIC 995 (9/08)

How to Edit Form Lic 995 Online for Free

We've applied the hard work of our best developers to create the PDF editor you intend to apply. Our application will allow you to fill in the Caregiver document effortlessly and don’t waste time. What you need to do is comply with these simple instructions.

Step 1: To begin with, choose the orange "Get form now" button.

Step 2: The document editing page is presently open. It's possible to add text or edit existing information.

Type in the data requested by the application to prepare the form.

gov gaps to complete

Jot down the data in the NameofChildCareCenter, Date, parentauthorizedrepresentative, and LIC area.

gov NameofChildCareCenter, Date, parentauthorizedrepresentative, and LIC fields to complete

Step 3: Select the button "Done". The PDF file may be exported. It's possible to upload it to your laptop or email it.

Step 4: It can be better to maintain copies of your form. You can rest easy that we are not going to reveal or see your information.

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