LIC 9052: California Notice of Employee Rights

The child care facility licensee is required to give the employee this form, to have the employee complete and detach the bottom of the form, and to maintain the signed acknowledgement of receipt of the form in the employee's file.

After "This is to acknowledge that I", print the name of the employee, who has received a copy of "EMPLOYEE RIGHTS" from the employer.

After "employer", print the name of the employer; after "authorized representative of", print the name of the facility. The employer is the licensee or authorized representative of the facility.

The employee signs on the Signature of Employee line and completes the Date line.

Pursuant to Health and Safety Code Section 1596.882, an employee alleging the violation by the employer of any action described on the form shall do the following: present the employer with a claim alleging violation of the employee's rights within 45 days after the discharge, demotion, suspension or threat thereof or for discriminating against the employee for taking such action; and file a claim with the Division of Labor Standards Enforcement no later than 90 days after the employer takes any of the actions described on the form against the employee.

Upon receipt of the employee's complaint, the Division of Labor Standards Enforcement shall do whatever investigation it deems appropriate to resolve the complaint.

Within 30 days of receipt of a complaint from an employee as outlined above, the Division of Labor Standards Enforcement shall review the facts of the complaint and set either a hearing date or notify the employee and the employer of its decision.

Except for any grievance procedure or arbitration or hearing that is available to the employee pursuant to a collective bargaining agreement, Section 1596.882 is the exclusive means for presenting claims.

To file a claim with the Division of Labor Standards Enforcement, check the white pages of the local telephone directory under State Government Offices, California State of, Industrial relations Department, Labor Standards Enforcement-Working Conditions, for the local telephone number and address of the nearest office, or contact the headquarters office at P.O. Box 603, San Francisco, CA 94101, telephone (415) 703-4810.

This form is intended to meet the requirements of Health and Safety Code Sections 1596.881 and 1596.882, which require that employees be informed, at the time of employment, of their rights to file complaints against their employer for violating any licensing law or regulation.

Pursuant to Health and Safety Code Section 1596.882, an employee alleging the violation by the employer of any action described on the form shall do the following: present the employer with a claim alleging violation of the employee's rights within 45 days after the discharge, demotion, suspension or threat thereof or for discriminating against the employee for taking such action; and file a claim with the Division of Labor Standards Enforcement no later than 90 days after the employer takes any of the actions described on the form against the employee.

The child care facility licensee is required to give the employee this form, to have the employee complete and detach the bottom of the form, and to maintain the signed acknowledgement of receipt of the form in the employee's file.