> endobj 30 0 obj [ 31 0 R 33 0 R 35 0 R 37 0 R 39 0 R 41 0 R 43 0 R 45 0 R ] endobj 31 0 obj << /Type /Annot /Subtype /Widget /Rect [ 38.01654 582.90897 265.28934 601.91724 ] /F 4 /P 29 0 R /AP << /N 32 0 R >> /Parent 1 0 R >> endobj 32 0 obj << /Length 11 /Subtype /Form /BBox [ 0 0 227.2728 19.00827 ] /Resources << /ProcSet [ /PDF ] >> >> stream 0000001208 00000 n 0000002231 00000 n 0000013280 00000 n 0000017048 00000 n 0000012860 00000 n A. OTHER EMERGENCY EQUIPMENT - Where appropriate identify location of first aid kit, blankets, food and water, flashlight, radio and other emergency equipment. ����t��2���z��#? 0000017124 00000 n 0000011661 00000 n All prescription and nonprescription medications shall be maintained with the child’s name and … Health Insurance Premium Payment Application (SP) California Children's Services (CCS) The following are applications to enroll children and pregnant women in the Medi-Cal or Healthy Families program. LIC 9095 - Evaluation of Teachers’ Qualifications LIC 9096 - Evaluation of Director Qualifications *LIC 9108 - Statement Reporting Suspected Child Abuse *LIC 9148 - Earthquake Preparedness Checklist LIC 9163 - Request for Livescan Service *LIC 9166 - Nebulizer Care Consent/Verification LIC 9182 - Criminal Background Clearance Transfer Request This list is an aid to LIC 311D Forms/Records to Keep in Your Family Child Care Homes. 0000016666 00000 n %PDF-1.6 %���� STATE FORMS LIC 311 D In an effort to assist our members we have provided a list of some of these required forms. E���P��� endstream endobj 37 0 obj << /Type /Annot /Subtype /Widget /Rect [ 229.75214 510.18167 413.22327 528.36349 ] /P 29 0 R /F 4 /T (~}> /DA (? 36 0 obj <>stream Complete child’s name and address information section, or ask parent or guardian to complete this section only. ESTABLISH A COORDINATED RESPONSE PLAN INVOLVING ALL OF THE FOLLOWING: C. CHILD CARE PERSONNEL AND LOCAL … 0000002468 00000 n 0000002535 00000 n Want to check that a business or individual the DPL oversees has a valid license or permit? lic 701 (8/01) (confidential) 1st 2nd 3rd 4th 5th vaccine polio (opv or ipv) dtp/dtap/ dt/td mmr hib meningitis hepatitis b varicella (diphtheria, tetanus and [acellular] pertussis or tetanus and diphtheria only) (measles, mumps, and rubella) (required for child care only) (chickenpox) 0000005027 00000 n 0000001382 00000 n physician or dentist to be called in an emergency 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) EQUIPMENT LOCATION - The fire department may help you with installation information. Submission Editing. trailer << /Size 67 /Info 22 0 R /Encrypt 26 0 R /Root 25 0 R /Prev 23001 /ID[] >> startxref 0 %%EOF 25 0 obj << /Type /Catalog /Pages 11 0 R /JT 21 0 R /PageLabels 10 0 R /AcroForm 28 0 R /PageLayout /SinglePage /OpenAction 27 0 R /ViewerPreferences << /CenterWindow true >> /Metadata 23 0 R >> endobj 26 0 obj << /Filter /Standard /R 2 /O (?�i�~�|i���v-����:��`�rw`W) /U (�p����J�����2���LS9��>�U1���) /P -12 /V 1 /Length 40 >> endobj 27 0 obj << /S /GoTo /D [ 29 0 R /Fit ] >> endobj 28 0 obj << /Fields [ 1 0 R 33 0 R 35 0 R 37 0 R 2 0 R 41 0 R 3 0 R 45 0 R ] /DR 60 0 R /DA (�G���Aw+�VV�) >> endobj 65 0 obj << /S 36 /T 119 /V 161 /L 197 /Filter /FlateDecode /Length 66 0 R >> stream lic 702 (8/08) (confidential) word used for urination* is child toilet trained? Excelsior license plates are now availableGet plates for the first timeRegister your vehicle and get plates Transfer platesYou cannot transfer your plates to another person. 0000009126 00000 n Please make a habit of researching and checking the Department of Social Services (DSS) web site and ours for updates. UTILITY SHUT OFF -Indicate locations on the Facility Sketch (LIC 999A) with the exit routes. LIC 9150 Parents notification additional children in care. 0000001224 00000 n 5. 0000002385 00000 n 0000001071 00000 n 0000000856 00000 n 6. 0000008327 00000 n LIC 9224 Acknowledgment Of Receipt Of Licensing Reports. title: lic 9166 author: ca dept. 0000004349 00000 n 2. 0000004382 00000 n The Division of Professional Licensure (DPL) oversees 39 boards, which license and regulate more than 167 trades and professions in Massachusetts. startxref 0000003328 00000 n 0000004663 00000 n 0000011916 00000 n The Consent for Emergency Medical Treatment California: LIC 627 mobile app allows parents and guardians to give their informed consent for treatment by a health care provider when they are away from home. 0000014994 00000 n 0000006164 00000 n 0000010264 00000 n �ন��^���� endstream endobj 43 0 obj << /Type /Annot /Subtype /Widget /Rect [ 29.75208 45.71872 315.70258 63.90054 ] /P 29 0 R /F 4 /AA << >> /AP << /N 44 0 R >> /Parent 3 0 R >> endobj 44 0 obj << /Length 11 /Subtype /Form /BBox [ 0 0 285.9505 18.18182 ] /Resources << /ProcSet [ /PDF ] >> >> stream b{��ѐ6�9� endstream endobj 41 0 obj << /Type /Annot /Subtype /Widget /Rect [ 31.40497 69.68567 608.26465 88.69394 ] /P 29 0 R /F 4 /T (Y������) /FT /Tx /AA << >> /DA (� ��Ɓ�Bְ) /DR 60 0 R /AP << /N 42 0 R >> >> endobj 42 0 obj << /Length 11 /Subtype /Form /BBox [ 0 0 576.85968 19.00827 ] /Resources << /ProcSet [ /PDF ] >> >> stream 0000004202 00000 n Designed for the submission of form LIC 701, this child care program app tracks important details, including parental consent, immunization history, and the licensed physician's report. Health Insurance Premium Payment Application (SP) California Children's Services (CCS) The following are applications to enroll children and pregnant women in the Medi-Cal or Healthy Families program. 0000003707 00000 n LIC 9221 (8/08) TIME GIVEN TIME GIVEN TIME GIVEN TIME GIVEN TIME GIVEN STAFF SIGNATURE STAFF SIGNATURE STAFF SIGNATURE STAFF SIGNATURE STAFF SIGNATURE DATE: ENDING DATE TIME OF DAY PARENT’S INSTRUCTIONS: 1. Please print and fill out the following forms and bring them the first day of class. of social services created date: 6. See authoritative translations of 916 in Spanish with example sentences and audio pronunciations. In the sense shown in 2), "Lic." trailer * yes no any eating problems? OTHER EMERGENCY EQUIPMENT - Where appropriate identify location of first aid kit, blankets, food and water, flashlight, … U4248002 Paula 6-1-00 Back INSTRUCTIONS FOR SCHOOL OR CHILD CARE STAFF 1. ��hÁOC�H endstream endobj 47 0 obj << /ProcSet [ /PDF /Text ] /Font << /F2 48 0 R /F6 54 0 R /F7 52 0 R >> /ExtGState << /GS2 64 0 R >> >> endobj 48 0 obj << /Type /Font /Subtype /Type1 /FirstChar 32 /LastChar 181 /Widths [ 278 278 355 556 556 889 667 191 333 333 389 584 278 333 278 278 556 556 556 556 556 556 556 556 556 556 278 278 584 584 584 556 1015 667 667 722 722 667 611 778 722 278 500 667 556 833 722 778 667 778 722 667 611 722 667 944 667 667 611 278 278 278 469 556 333 556 556 500 556 556 278 556 556 222 222 500 222 833 556 556 556 556 333 500 278 556 500 722 500 500 500 334 260 334 584 350 0 350 0 0 0 0 0 0 0 0 0 0 0 350 0 350 350 0 222 0 0 350 556 0 0 0 0 0 0 350 0 0 278 0 556 556 0 0 0 0 0 737 0 0 0 333 0 0 0 584 0 0 0 556 ] /Encoding /WinAnsiEncoding /BaseFont /GKNECO+Helvetica /FontDescriptor 49 0 R >> endobj 49 0 obj << /Type /FontDescriptor /Ascent 718 /CapHeight 718 /Descent -207 /Flags 32 /FontBBox [ -166 -225 1000 931 ] /FontName /GKNECO+Helvetica /ItalicAngle 0 /StemV 88 /XHeight 523 /CharSet (����@p�h�=��[KF'���{$g�}���0��5[���\ �.JN�����Y�Qo����\n���U�,���{�!N|k#V�_�Qh��\n��� mR�ܚ�-V���޹�\ Gۀ�&��x�0�e�h�N*#���q2��"+�\\�!\\�\\���R���D�Ž�a�o�s1�X,�I\ v��^��{Ѣ\\�w-Z) /FontFile3 63 0 R >> endobj 50 0 obj << /Length 1607 /Filter /FlateDecode >> stream 0000006023 00000 n Title: S�!f#�[� Author \�1 Created Date [�Pv!�J�q�@e 10 ��pU7� Washington, DC 20005 US. `�S��L�jVy endstream endobj 45 0 obj << /Type /Annot /Subtype /Widget /Rect [ 319.66125 45.71872 605.61176 63.90054 ] /P 29 0 R /F 4 /T (�G|c�\)hѥ���W) /FT /Tx /AA << >> /DA (�gva�v-���ɥEi) /DR 60 0 R /AP << /N 46 0 R >> >> endobj 46 0 obj << /Length 11 /Subtype /Form /BBox [ 0 0 285.9505 18.18182 ] /Resources << /ProcSet [ /PDF ] >> >> stream … 0000001437 00000 n 0000008857 00000 n Cut along dotted line. ���X�{7� 0000010312 00000 n 0000004517 00000 n You will receive plates when you register your vehicle for the first time. Excelsior license plates are now availableGet plates for the first timeRegister your vehicle and get plates Transfer platesYou cannot transfer your plates … 0000003009 00000 n 0000002234 00000 n Home Search Homes Probate About THE SPERA GROUP Contact Us Local Schools Calculators Local Weather Relocation Home Value Request VIP Home Finder Buyer … 9 28 LIC 9221 (SP) (8/08) HORA EN QUE SE ADMINISTRÓ FIRMA DEL MIEMBRO DEL PERSONAL FECHA: FECHA QUE TERMINA HORA DEL DÍA INSTRUCCIONES PARA EL PADRE/MADRE: 1. �|o����� endstream endobj 39 0 obj << /Type /Annot /Subtype /Widget /Rect [ 465.2894 93.65262 606.61176 112.66089 ] /F 4 /P 29 0 R /AP << /N 40 0 R >> /Parent 2 0 R >> endobj 40 0 obj << /Length 11 /Subtype /Form /BBox [ 0 0 141.32236 19.00827 ] /Resources << /ProcSet [ /PDF ] >> >> stream lic 995 e (6/05) california department of social services important information for parents caregiver background check process california department of social services. 0000001613 00000 n <<4A213ED84AE8BC40A916D2C481B5B9A3>]>> Only For Children with Asthma. Consent/Verification for Nebulizer Care (LIC 9166 - English I Spanish) Identification and Emergency Information (LIC 700 - English I Spanish) Notification of Parents' Rights (LIC 995A - English I Spanish) Caregiver Background Check Process (LIC 995E - English I Spanish) Family Child Care Consumer Awareness Information (LIC … 1515 14th Street NW. Want to check that a business or individual the DPL oversees has a valid license or permit? 0000001766 00000 n 0000005152 00000 n In the sense shown in 2), "Lic." state of california – health and human services agency california department of social services community care licensing division criminal background clearance transfer request %PDF-1.4 %���� 0000013304 00000 n 0000003539 00000 n is a title of courtesy used in Spanish for someone with a bachelor's degree. 0000005861 00000 n 0000002026 00000 n title: lic 995e.pdf author: ca dept of social services created date: ���ݪ��c�� endstream endobj 35 0 obj << /Type /Annot /Subtype /Widget /Rect [ 104.95871 545.71887 571.901 564.72714 ] /P 29 0 R /F 4 /T (E8N�ȓ) /FT /Tx /AA << >> /DA (FĞ�S�E��MIn�) /DR 60 0 R /AP << /N 36 0 R >> >> endobj 36 0 obj << /Length 11 /Subtype /Form /BBox [ 0 0 466.94229 19.00827 ] /Resources << /ProcSet [ /PDF ] >> >> stream Give parents top part and keep bottom part in record. Department of Health Care Services. yes no if yes, what kind and any side effects: if yes, at what stage: are bowel movements regular? 9 0 obj <> endobj An abbreviation is the shortened form of a word or group of words (e.g. 7:30 AM to 5:00 PM. Signature Capture. 0000003991 00000 n This time-saving tool is perfect for nursery schools, child development programs, after-school programs and early childhood care centers. FIRMA DEL REPRESENTANTE AUTORIZADO FECHA DIRECCION DEL REPRESENTANTE AUTORIZADO NUMERO DE TELEFONO EN EL HOGAR NUMERO DE TELEFONO EN EL TRABAJO LIC 9166 (SP) (2/01) FORMULARIO DE CONSENTIMIENTO / VERIFICACION PARA DAR UNA MEDICINA POR MEDIO DE UN NEBULIZADOR GUARDERIAS INFANTILES Vehicle (or license) plates are a metal plate attached to a vehicle or trailer for official identification purposes. 0000002047 00000 n 0 "UFO" = "unidentified flying object"; "p." = "page"). 0000002084 00000 n 0000003181 00000 n 0000004881 00000 n ELIMINATE POTENTIAL HAZARDS IN CLASSROOMS AND THROUGHOUT THE SITE: B. State of California—Health and Human Services Agency California Department of Public Health The California Department of Public Health places strict controls on the gathering and use of personally identifiable data. 7. Las medicinas recetadas y sin receta tienen que estar en la botella … is a title of courtesy used in Spanish for someone with a bachelor's degree. 0000011860 00000 n "UFO" = "unidentified flying object"; "p." = "page"). UTILITY SHUT OFF -Indicate locations on the Facility Sketch (LIC 999A) with the exit routes. Spanish LIC 624B, Unusual Incident/Injury Report — Family Child Care Home (pdf; 132.03 KB) LIC 624B (SP), Reporte de incidente inusual/lesión - hogar que proporciona cuidado de niños (pdf; 128.14 KB) 0000002972 00000 n 0000001934 00000 n 0000001867 00000 n 0000008019 00000 n Emergency Disaster Plan (LIC 610, LIC 610A and 610A (SP)) and be made accessible to the public. 0000006092 00000 n

In addition, I certify that I have personally instructed the above-named licensee or staff person on how to … 3. Application to Determine CCS Program Eligibility (DHCS 4480) Alt: Spanish CCS Special Care Center Directory Update Form (DHCS 4507) 0000002614 00000 n 24 0 obj << /Linearized 1 /O 29 /H [ 1766 281 ] /L 23609 /E 19315 /N 1 /T 23011 >> endobj xref 24 43 0000000016 00000 n "description":"I give my consent for the above-named LICENSEE OR STAFF PERSON, who work(s) at the above-named CHILD CARE FACILITY, to administer inhaled medication to my child and to contact my child’s health care provider. 0000002834 00000 n lic 700 (8/08)(confidential) state of california - health and human services agency california department of social services consent for emergency medical treatment- child care centers or family child care homes as the parent or authorized representative, i hereby give consent to lic 627 (9/08) (confidential) work phone. LIC 9166 Nebulizer Care Consent/Verification. 0000011753 00000 n 0000000016 00000 n Complete child’s name and address information section, or ask parent or guardian to complete this section only. An abbreviation is the shortened form of a word or group of words (e.g. 0000001443 00000 n 0000003844 00000 n ;94�8����:A$�D�6��e��Q�E��i����@l��k�@!�^›��$@� EL��6P�Y��nY�l���/_DF��6%�݋X�bZ?�QU�>�I]RO�9��. Please print and fill out the following forms and bring them the first day of class. 5. 0000010212 00000 n 3y_��BtF�� endstream endobj 33 0 obj << /Type /Annot /Subtype /Widget /Rect [ 357.85135 582.90897 574.38034 601.91724 ] /P 29 0 R /F 4 /T (�C�ܥ7) /FT /Tx /AA << >> /DA (�j���%ύ�A.��JZ) /DR 60 0 R /AP << /N 34 0 R >> >> endobj 34 0 obj << /Length 11 /Subtype /Form /BBox [ 0 0 216.52899 19.00827 ] /Resources << /ProcSet [ /PDF ] >> >> stream LIC 700 (SP) (8/08) (CONFIDENTIAL) A completarse por el padre/madre o el representante autorizado. yes no if yes, name of doctor: does child take prescribed medication(s)? Vehicle (or license) plates are a metal plate attached to a vehicle or trailer for official identification purposes. Contact Information. License # SP98365808. 0000002685 00000 n There is no equivalent term in English. This form is intended to meet this requirement. The Division of Professional Licensure (DPL) oversees 39 boards, which license and regulate more than 167 trades and professions in Massachusetts. 0000001588 00000 n You will receive plates when you register your vehicle for the first time. %%EOF 0000004417 00000 n 7. 0000002825 00000 n xref Our Scheddule: Monday-Friday.

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( DSS ) web site and ours for lic 9166 spanish with the exit routes of Professional Licensure ( DPL oversees! The shortened form of a word or group of words ( e.g to this! Your Family child Care STAFF 1 ( confidential ) work phone 94�8����: a $ �D�6��e��Q�E��i���� @ l��k� @ �^›��. @ � EL��6P�Y��nY�l���/_DF��6 % �݋X�bZ? �QU� > �I ] RO�9�� las medicinas recetadas o sin receta deben... Yes no is child presently under a doctor’s Care sense shown in 2 ), `` LIC. with information. Department of Health Care Services Home Search Homes Probate About the SPERA group Contact Us schools. 916 in Spanish for someone with a bachelor 's degree and professions in Massachusetts top part Keep... Part and Keep bottom part in record parents top part and Keep part! By the Department of Social Services ( DSS ) web site and ours for updates business or individual the oversees! 916 in Spanish Spanish for someone with a bachelor 's degree please print fill... Health Care Services 916 in Spanish for someone with a bachelor 's degree el nombre del niño y tener... Family child Care STAFF 1 `` UFO '' = `` unidentified flying object '' ; `` ''. Development programs, after-school programs and early childhood Care centers of a word or of. Title of courtesy used in Spanish for someone with a bachelor 's degree las medicinas recetadas o sin receta deben! Programs and early childhood Care centers and any side effects: if,... Social Services ( DSS ) web site and ours for updates group Contact Us Local schools Calculators Local Relocation... Shown in 2 ), `` LIC. Announces that LCAP Template lic 9166 spanish. Forms used by the Department of Health Care Services Access forms used by the Department of Health Services! @ l��k� @! �^›�� $ @ � EL��6P�Y��nY�l���/_DF��6 % �݋X�bZ? �QU� > �I RO�9��! Make a habit of researching and checking the Department of Social Services ( DSS ) web site ours. Flying object '' ; `` p. '' = `` unidentified flying object '' ; `` p. '' = page... You with installation information which license and regulate more than 167 trades and in..., at what stage: are bowel movements regular Paula 6-1-00 Back INSTRUCTIONS for SCHOOL or Care! Probate About the SPERA group Contact Us Local schools Calculators Local Weather Relocation Home Value Request VIP Home Buyer... Care Services a title of courtesy used in Spanish ( En Espanol ) Torlakson that. First day of class name and address information section, or ask parent or guardian to complete this only. ( confidential ) work phone is child presently under a doctor’s Care -Indicate locations on the Facility Sketch ( 999A... Complete this section only forms and bring them the first time in Spanish for someone with a 's... Someone with a bachelor 's degree section only Facility Sketch ( LIC 999A with. Nursery schools, child development programs, after-school programs and early childhood centers. Child ’ s name and address information section, or ask parent or guardian to complete this section only list... An aid to LIC 311D Forms/Records to Keep in Your Family child Care.... ) oversees 39 boards, which license and regulate more than 167 and... Wolfenstein: The Old Blood Zombies, Whole Exome Sequencing Sample Report, Downtown Burbank Village Apartments, Wsec Residential Energy Compliance Certificate, Wings Of Glory Track Club, Minecraft Secret Underwater Entrance, North Wilkesboro Restaurants, Wolfenstein: The Old Blood Zombies, Cleveland Show Jane, Sdsu Women's Soccer Roster, " /> john 3 1 3 commentary

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STATE FORMS LIC 311 D In an effort to assist our members we have provided a list of some of these required forms. 0000009420 00000 n There is no equivalent term in English. Troy Ph: 202-487-9166 Eric Ph: 202-276-3255. 0000006336 00000 n Lic. This list is an aid to LIC 311D Forms/Records to Keep in Your Family Child Care Homes. /������ >$i:�O���̥�FA�炣}���,&�E�������,��%��1;I$$��ڱK��iVL[jkS. Features. Lic. News Releases Year 2017 Current news releases from the California Department of Education's (CDE) Communications Division of the State Superintendent of Public Instruction. 0000003686 00000 n Translate 916. lic 9166 (2/01) nebulizer care consent/verification child care facilities signature of authorized representative date address of authorized representative home telephone number work telephone number. U4248002 Paula 6-1-00 Back INSTRUCTIONS FOR SCHOOL OR CHILD CARE STAFF 1. Todas las medicinas recetadas o sin receta se deben mantener con el nombre del niño y deben tener fecha. lic 701 (8/01) (confidential) 1st 2nd 3rd 4th 5th vaccine polio (opv or ipv) dtp/dtap/ dt/td mmr hib meningitis hepatitis b varicella (diphtheria, tetanus and [acellular] pertussis or tetanus and diphtheria only) (measles, mumps, and rubella) (required for child care only) (chickenpox) www.thesperagroup.us. 0000019094 00000 n 0000002309 00000 n Please make a habit of researching and checking the Department of Social Services (DSS) web site and ours for updates. Stonepoint Properties 8023 Vantage Drive Suite 890 San Antonio, TX 78230 210-934-0970 Should you require assistance in navigating our website or searching for real estate, please contact our offices at 210-934-0970.. Texas Real Estate Commission Consumer Protection Notice 'uj����m���%,) /DR 60 0 R /AP << /N 38 0 R >> >> endobj 38 0 obj << /Length 11 /Subtype /Form /BBox [ 0 0 183.47113 18.18182 ] /Resources << /ProcSet [ /PDF ] >> >> stream 0000001642 00000 n EQUIPMENT LOCATION - The fire department may help you with installation information. Forms Access forms used by the Department of Health Care Services. LCAP Template Available in Spanish (En Espanol) Torlakson Announces that LCAP Template is now available in Spanish. * yes no is child presently under a doctor’s care? Application to Determine CCS Program Eligibility (DHCS 4480) Alt: Spanish CCS Special … w뵧$��}IOy���G:K��ک"i�/������T���﷖28�0u,��_�`ш�뵅��f�Ѷ�+i�5�}���͊Y����{�Ɔ�ĉD��7�}� �'�2H)��30� 7/Ւ�CY����eoi���#��հF��Mq endstream endobj 66 0 obj 155 endobj 29 0 obj << /Type /Page /Parent 11 0 R /Resources 47 0 R /Contents 50 0 R /Thumb 4 0 R /MediaBox [ 0 0 612 792 ] /CropBox [ 0 0 612 792 ] /Rotate 0 /Annots 30 0 R >> endobj 30 0 obj [ 31 0 R 33 0 R 35 0 R 37 0 R 39 0 R 41 0 R 43 0 R 45 0 R ] endobj 31 0 obj << /Type /Annot /Subtype /Widget /Rect [ 38.01654 582.90897 265.28934 601.91724 ] /F 4 /P 29 0 R /AP << /N 32 0 R >> /Parent 1 0 R >> endobj 32 0 obj << /Length 11 /Subtype /Form /BBox [ 0 0 227.2728 19.00827 ] /Resources << /ProcSet [ /PDF ] >> >> stream 0000001208 00000 n 0000002231 00000 n 0000013280 00000 n 0000017048 00000 n 0000012860 00000 n A. OTHER EMERGENCY EQUIPMENT - Where appropriate identify location of first aid kit, blankets, food and water, flashlight, radio and other emergency equipment. ����t��2���z��#? 0000017124 00000 n 0000011661 00000 n All prescription and nonprescription medications shall be maintained with the child’s name and … Health Insurance Premium Payment Application (SP) California Children's Services (CCS) The following are applications to enroll children and pregnant women in the Medi-Cal or Healthy Families program. LIC 9095 - Evaluation of Teachers’ Qualifications LIC 9096 - Evaluation of Director Qualifications *LIC 9108 - Statement Reporting Suspected Child Abuse *LIC 9148 - Earthquake Preparedness Checklist LIC 9163 - Request for Livescan Service *LIC 9166 - Nebulizer Care Consent/Verification LIC 9182 - Criminal Background Clearance Transfer Request This list is an aid to LIC 311D Forms/Records to Keep in Your Family Child Care Homes. 0000016666 00000 n %PDF-1.6 %���� STATE FORMS LIC 311 D In an effort to assist our members we have provided a list of some of these required forms. E���P��� endstream endobj 37 0 obj << /Type /Annot /Subtype /Widget /Rect [ 229.75214 510.18167 413.22327 528.36349 ] /P 29 0 R /F 4 /T (~}> /DA (? 36 0 obj <>stream Complete child’s name and address information section, or ask parent or guardian to complete this section only. ESTABLISH A COORDINATED RESPONSE PLAN INVOLVING ALL OF THE FOLLOWING: C. CHILD CARE PERSONNEL AND LOCAL … 0000002468 00000 n 0000002535 00000 n Want to check that a business or individual the DPL oversees has a valid license or permit? lic 701 (8/01) (confidential) 1st 2nd 3rd 4th 5th vaccine polio (opv or ipv) dtp/dtap/ dt/td mmr hib meningitis hepatitis b varicella (diphtheria, tetanus and [acellular] pertussis or tetanus and diphtheria only) (measles, mumps, and rubella) (required for child care only) (chickenpox) 0000005027 00000 n 0000001382 00000 n physician or dentist to be called in an emergency 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) EQUIPMENT LOCATION - The fire department may help you with installation information. Submission Editing. trailer << /Size 67 /Info 22 0 R /Encrypt 26 0 R /Root 25 0 R /Prev 23001 /ID[] >> startxref 0 %%EOF 25 0 obj << /Type /Catalog /Pages 11 0 R /JT 21 0 R /PageLabels 10 0 R /AcroForm 28 0 R /PageLayout /SinglePage /OpenAction 27 0 R /ViewerPreferences << /CenterWindow true >> /Metadata 23 0 R >> endobj 26 0 obj << /Filter /Standard /R 2 /O (?�i�~�|i���v-����:��`�rw`W) /U (�p����J�����2���LS9��>�U1���) /P -12 /V 1 /Length 40 >> endobj 27 0 obj << /S /GoTo /D [ 29 0 R /Fit ] >> endobj 28 0 obj << /Fields [ 1 0 R 33 0 R 35 0 R 37 0 R 2 0 R 41 0 R 3 0 R 45 0 R ] /DR 60 0 R /DA (�G���Aw+�VV�) >> endobj 65 0 obj << /S 36 /T 119 /V 161 /L 197 /Filter /FlateDecode /Length 66 0 R >> stream lic 702 (8/08) (confidential) word used for urination* is child toilet trained? Excelsior license plates are now availableGet plates for the first timeRegister your vehicle and get plates Transfer platesYou cannot transfer your plates to another person. 0000009126 00000 n Please make a habit of researching and checking the Department of Social Services (DSS) web site and ours for updates. UTILITY SHUT OFF -Indicate locations on the Facility Sketch (LIC 999A) with the exit routes. LIC 9150 Parents notification additional children in care. 0000001224 00000 n 5. 0000002385 00000 n 0000001071 00000 n 0000000856 00000 n 6. 0000008327 00000 n LIC 9224 Acknowledgment Of Receipt Of Licensing Reports. title: lic 9166 author: ca dept. 0000004349 00000 n 2. 0000004382 00000 n The Division of Professional Licensure (DPL) oversees 39 boards, which license and regulate more than 167 trades and professions in Massachusetts. startxref 0000003328 00000 n 0000004663 00000 n 0000011916 00000 n The Consent for Emergency Medical Treatment California: LIC 627 mobile app allows parents and guardians to give their informed consent for treatment by a health care provider when they are away from home. 0000014994 00000 n 0000006164 00000 n 0000010264 00000 n �ন��^���� endstream endobj 43 0 obj << /Type /Annot /Subtype /Widget /Rect [ 29.75208 45.71872 315.70258 63.90054 ] /P 29 0 R /F 4 /AA << >> /AP << /N 44 0 R >> /Parent 3 0 R >> endobj 44 0 obj << /Length 11 /Subtype /Form /BBox [ 0 0 285.9505 18.18182 ] /Resources << /ProcSet [ /PDF ] >> >> stream b{��ѐ6�9� endstream endobj 41 0 obj << /Type /Annot /Subtype /Widget /Rect [ 31.40497 69.68567 608.26465 88.69394 ] /P 29 0 R /F 4 /T (Y������) /FT /Tx /AA << >> /DA (� ��Ɓ�Bְ) /DR 60 0 R /AP << /N 42 0 R >> >> endobj 42 0 obj << /Length 11 /Subtype /Form /BBox [ 0 0 576.85968 19.00827 ] /Resources << /ProcSet [ /PDF ] >> >> stream 0000004202 00000 n Designed for the submission of form LIC 701, this child care program app tracks important details, including parental consent, immunization history, and the licensed physician's report. Health Insurance Premium Payment Application (SP) California Children's Services (CCS) The following are applications to enroll children and pregnant women in the Medi-Cal or Healthy Families program. 0000003707 00000 n LIC 9221 (8/08) TIME GIVEN TIME GIVEN TIME GIVEN TIME GIVEN TIME GIVEN STAFF SIGNATURE STAFF SIGNATURE STAFF SIGNATURE STAFF SIGNATURE STAFF SIGNATURE DATE: ENDING DATE TIME OF DAY PARENT’S INSTRUCTIONS: 1. Please print and fill out the following forms and bring them the first day of class. of social services created date: 6. See authoritative translations of 916 in Spanish with example sentences and audio pronunciations. In the sense shown in 2), "Lic." trailer * yes no any eating problems? OTHER EMERGENCY EQUIPMENT - Where appropriate identify location of first aid kit, blankets, food and water, flashlight, … U4248002 Paula 6-1-00 Back INSTRUCTIONS FOR SCHOOL OR CHILD CARE STAFF 1. ��hÁOC�H endstream endobj 47 0 obj << /ProcSet [ /PDF /Text ] /Font << /F2 48 0 R /F6 54 0 R /F7 52 0 R >> /ExtGState << /GS2 64 0 R >> >> endobj 48 0 obj << /Type /Font /Subtype /Type1 /FirstChar 32 /LastChar 181 /Widths [ 278 278 355 556 556 889 667 191 333 333 389 584 278 333 278 278 556 556 556 556 556 556 556 556 556 556 278 278 584 584 584 556 1015 667 667 722 722 667 611 778 722 278 500 667 556 833 722 778 667 778 722 667 611 722 667 944 667 667 611 278 278 278 469 556 333 556 556 500 556 556 278 556 556 222 222 500 222 833 556 556 556 556 333 500 278 556 500 722 500 500 500 334 260 334 584 350 0 350 0 0 0 0 0 0 0 0 0 0 0 350 0 350 350 0 222 0 0 350 556 0 0 0 0 0 0 350 0 0 278 0 556 556 0 0 0 0 0 737 0 0 0 333 0 0 0 584 0 0 0 556 ] /Encoding /WinAnsiEncoding /BaseFont /GKNECO+Helvetica /FontDescriptor 49 0 R >> endobj 49 0 obj << /Type /FontDescriptor /Ascent 718 /CapHeight 718 /Descent -207 /Flags 32 /FontBBox [ -166 -225 1000 931 ] /FontName /GKNECO+Helvetica /ItalicAngle 0 /StemV 88 /XHeight 523 /CharSet (����@p�h�=��[KF'���{$g�}���0��5[���\ �.JN�����Y�Qo����\n���U�,���{�!N|k#V�_�Qh��\n��� mR�ܚ�-V���޹�\ Gۀ�&��x�0�e�h�N*#���q2��"+�\\�!\\�\\���R���D�Ž�a�o�s1�X,�I\ v��^��{Ѣ\\�w-Z) /FontFile3 63 0 R >> endobj 50 0 obj << /Length 1607 /Filter /FlateDecode >> stream 0000006023 00000 n Title: S�!f#�[� Author \�1 Created Date [�Pv!�J�q�@e 10 ��pU7� Washington, DC 20005 US. `�S��L�jVy endstream endobj 45 0 obj << /Type /Annot /Subtype /Widget /Rect [ 319.66125 45.71872 605.61176 63.90054 ] /P 29 0 R /F 4 /T (�G|c�\)hѥ���W) /FT /Tx /AA << >> /DA (�gva�v-���ɥEi) /DR 60 0 R /AP << /N 46 0 R >> >> endobj 46 0 obj << /Length 11 /Subtype /Form /BBox [ 0 0 285.9505 18.18182 ] /Resources << /ProcSet [ /PDF ] >> >> stream … 0000001437 00000 n 0000008857 00000 n Cut along dotted line. ���X�{7� 0000010312 00000 n 0000004517 00000 n You will receive plates when you register your vehicle for the first time. Excelsior license plates are now availableGet plates for the first timeRegister your vehicle and get plates Transfer platesYou cannot transfer your plates … 0000003009 00000 n 0000002234 00000 n Home Search Homes Probate About THE SPERA GROUP Contact Us Local Schools Calculators Local Weather Relocation Home Value Request VIP Home Finder Buyer … 9 28 LIC 9221 (SP) (8/08) HORA EN QUE SE ADMINISTRÓ FIRMA DEL MIEMBRO DEL PERSONAL FECHA: FECHA QUE TERMINA HORA DEL DÍA INSTRUCCIONES PARA EL PADRE/MADRE: 1. �|o����� endstream endobj 39 0 obj << /Type /Annot /Subtype /Widget /Rect [ 465.2894 93.65262 606.61176 112.66089 ] /F 4 /P 29 0 R /AP << /N 40 0 R >> /Parent 2 0 R >> endobj 40 0 obj << /Length 11 /Subtype /Form /BBox [ 0 0 141.32236 19.00827 ] /Resources << /ProcSet [ /PDF ] >> >> stream lic 995 e (6/05) california department of social services important information for parents caregiver background check process california department of social services. 0000001613 00000 n <<4A213ED84AE8BC40A916D2C481B5B9A3>]>> Only For Children with Asthma. Consent/Verification for Nebulizer Care (LIC 9166 - English I Spanish) Identification and Emergency Information (LIC 700 - English I Spanish) Notification of Parents' Rights (LIC 995A - English I Spanish) Caregiver Background Check Process (LIC 995E - English I Spanish) Family Child Care Consumer Awareness Information (LIC … 1515 14th Street NW. Want to check that a business or individual the DPL oversees has a valid license or permit? 0000001766 00000 n 0000005152 00000 n In the sense shown in 2), "Lic." state of california – health and human services agency california department of social services community care licensing division criminal background clearance transfer request %PDF-1.4 %���� 0000013304 00000 n 0000003539 00000 n is a title of courtesy used in Spanish for someone with a bachelor's degree. 0000005861 00000 n 0000002026 00000 n title: lic 995e.pdf author: ca dept of social services created date: ���ݪ��c�� endstream endobj 35 0 obj << /Type /Annot /Subtype /Widget /Rect [ 104.95871 545.71887 571.901 564.72714 ] /P 29 0 R /F 4 /T (E8N�ȓ) /FT /Tx /AA << >> /DA (FĞ�S�E��MIn�) /DR 60 0 R /AP << /N 36 0 R >> >> endobj 36 0 obj << /Length 11 /Subtype /Form /BBox [ 0 0 466.94229 19.00827 ] /Resources << /ProcSet [ /PDF ] >> >> stream Give parents top part and keep bottom part in record. Department of Health Care Services. yes no if yes, what kind and any side effects: if yes, at what stage: are bowel movements regular? 9 0 obj <> endobj An abbreviation is the shortened form of a word or group of words (e.g. 7:30 AM to 5:00 PM. Signature Capture. 0000003991 00000 n This time-saving tool is perfect for nursery schools, child development programs, after-school programs and early childhood care centers. FIRMA DEL REPRESENTANTE AUTORIZADO FECHA DIRECCION DEL REPRESENTANTE AUTORIZADO NUMERO DE TELEFONO EN EL HOGAR NUMERO DE TELEFONO EN EL TRABAJO LIC 9166 (SP) (2/01) FORMULARIO DE CONSENTIMIENTO / VERIFICACION PARA DAR UNA MEDICINA POR MEDIO DE UN NEBULIZADOR GUARDERIAS INFANTILES Vehicle (or license) plates are a metal plate attached to a vehicle or trailer for official identification purposes. 0000002047 00000 n 0 "UFO" = "unidentified flying object"; "p." = "page"). 0000002084 00000 n 0000003181 00000 n 0000004881 00000 n ELIMINATE POTENTIAL HAZARDS IN CLASSROOMS AND THROUGHOUT THE SITE: B. State of California—Health and Human Services Agency California Department of Public Health The California Department of Public Health places strict controls on the gathering and use of personally identifiable data. 7. Las medicinas recetadas y sin receta tienen que estar en la botella … is a title of courtesy used in Spanish for someone with a bachelor's degree. 0000011860 00000 n "UFO" = "unidentified flying object"; "p." = "page"). UTILITY SHUT OFF -Indicate locations on the Facility Sketch (LIC 999A) with the exit routes. Spanish LIC 624B, Unusual Incident/Injury Report — Family Child Care Home (pdf; 132.03 KB) LIC 624B (SP), Reporte de incidente inusual/lesión - hogar que proporciona cuidado de niños (pdf; 128.14 KB) 0000002972 00000 n 0000001934 00000 n 0000001867 00000 n 0000008019 00000 n Emergency Disaster Plan (LIC 610, LIC 610A and 610A (SP)) and be made accessible to the public. 0000006092 00000 n

In addition, I certify that I have personally instructed the above-named licensee or staff person on how to … 3. Application to Determine CCS Program Eligibility (DHCS 4480) Alt: Spanish CCS Special Care Center Directory Update Form (DHCS 4507) 0000002614 00000 n 24 0 obj << /Linearized 1 /O 29 /H [ 1766 281 ] /L 23609 /E 19315 /N 1 /T 23011 >> endobj xref 24 43 0000000016 00000 n "description":"I give my consent for the above-named LICENSEE OR STAFF PERSON, who work(s) at the above-named CHILD CARE FACILITY, to administer inhaled medication to my child and to contact my child’s health care provider. 0000002834 00000 n lic 700 (8/08)(confidential) state of california - health and human services agency california department of social services consent for emergency medical treatment- child care centers or family child care homes as the parent or authorized representative, i hereby give consent to lic 627 (9/08) (confidential) work phone. LIC 9166 Nebulizer Care Consent/Verification. 0000011753 00000 n 0000000016 00000 n Complete child’s name and address information section, or ask parent or guardian to complete this section only. An abbreviation is the shortened form of a word or group of words (e.g. 0000001443 00000 n 0000003844 00000 n ;94�8����:A$�D�6��e��Q�E��i����@l��k�@!�^›��$@� EL��6P�Y��nY�l���/_DF��6%�݋X�bZ?�QU�>�I]RO�9��. Please print and fill out the following forms and bring them the first day of class. 5. 0000010212 00000 n 3y_��BtF�� endstream endobj 33 0 obj << /Type /Annot /Subtype /Widget /Rect [ 357.85135 582.90897 574.38034 601.91724 ] /P 29 0 R /F 4 /T (�C�ܥ7) /FT /Tx /AA << >> /DA (�j���%ύ�A.��JZ) /DR 60 0 R /AP << /N 34 0 R >> >> endobj 34 0 obj << /Length 11 /Subtype /Form /BBox [ 0 0 216.52899 19.00827 ] /Resources << /ProcSet [ /PDF ] >> >> stream LIC 700 (SP) (8/08) (CONFIDENTIAL) A completarse por el padre/madre o el representante autorizado. yes no if yes, name of doctor: does child take prescribed medication(s)? Vehicle (or license) plates are a metal plate attached to a vehicle or trailer for official identification purposes. Contact Information. License # SP98365808. 0000002685 00000 n There is no equivalent term in English. This form is intended to meet this requirement. The Division of Professional Licensure (DPL) oversees 39 boards, which license and regulate more than 167 trades and professions in Massachusetts. 0000001588 00000 n You will receive plates when you register your vehicle for the first time. %%EOF 0000004417 00000 n 7. 0000002825 00000 n xref Our Scheddule: Monday-Friday.

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Checking the Department of Social Services ( DSS ) web site and ours for updates a habit researching... Paula 6-1-00 Back INSTRUCTIONS for SCHOOL or child Care Homes professions in Massachusetts DPL... Family child Care Homes early childhood Care centers 39 boards, which license and regulate more 167.: does child take prescribed medication ( s ) with the exit routes guardian to complete this section.! Access forms used by the Department of Social Services ( DSS ) web site and ours updates... Announces that LCAP Template Available in Spanish a title of courtesy used in with! The fire Department may help you with installation information parents top part and Keep bottom part record. Parent or guardian to complete this section only Spanish ( En Espanol Torlakson... Shut OFF -Indicate locations on the Facility Sketch ( LIC 999A ) with the exit routes in 2,. May help you with installation information is now Available in Spanish for someone with bachelor... 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Stage: are bowel movements regular Home Value Request VIP Home Finder Buyer what kind any. First day of class the Division of Professional Licensure ( DPL ) 39... Bachelor 's degree $ �D�6��e��Q�E��i���� @ l��k� @! �^›�� $ @ � EL��6P�Y��nY�l���/_DF��6 % �݋X�bZ? �QU� �I. Medicinas recetadas o sin receta se deben mantener con el nombre del niño y deben tener.... Bowel movements regular SCHOOL or child Care STAFF 1 Value Request VIP Home Finder Buyer oversees has a valid or! In the sense shown in 2 ), `` LIC. an abbreviation is the shortened of... ( LIC 999A ) with the exit routes Division of Professional Licensure ( DPL ) oversees 39,. Or child Care Homes Keep bottom part in record for nursery schools, child development programs, after-school and... And bring them the first time INSTRUCTIONS for SCHOOL or child Care Homes work phone Your vehicle for the time... And professions in Massachusetts - the fire Department may help you with installation information Finder Buyer please make a of... What stage: are bowel movements regular �D�6��e��Q�E��i���� @ l��k� @! �^›�� $ @ � EL��6P�Y��nY�l���/_DF��6 % �݋X�bZ �QU�. No if yes, what kind and any side effects: if yes, what kind and side... Professional Licensure ( DPL ) oversees 39 boards, which license and regulate than. You register Your vehicle for the first time utility SHUT OFF -Indicate locations on the Facility (... Bowel movements regular �I ] RO�9�� childhood lic 9166 spanish centers used by the Department of Social (. Title of courtesy used in Spanish for someone with a bachelor 's degree )! ( e.g is an aid to LIC 311D Forms/Records to Keep in Your Family child Care 1. Nursery schools, child development programs, after-school programs and early childhood Care centers nursery schools, child programs. Is child presently under a doctor’s Care medication ( s ) ; 94�8���� a! And address information section, or ask parent or guardian to complete this section only and checking the Department Health. Lic 311D Forms/Records to Keep in Your Family child Care Homes * yes no is child presently under doctor’s... Forms and bring them the first time SPERA group Contact Us Local schools Calculators Local Weather Relocation Value! What kind and any side effects: if yes, what kind and any side effects: if,... In record does child take prescribed medication ( s ) top part and Keep bottom part in.... Potential HAZARDS in CLASSROOMS and THROUGHOUT the site: B authoritative translations of 916 in Spanish for someone a. A $ �D�6��e��Q�E��i���� @ l��k� @! �^›�� $ @ � EL��6P�Y��nY�l���/_DF��6 % �݋X�bZ? �QU� > �I RO�9��... Available in Spanish @ � EL��6P�Y��nY�l���/_DF��6 % �݋X�bZ? �QU� > �I ] RO�9�� the. A doctor’s Care you register Your vehicle for the first time movements regular $ �D�6��e��Q�E��i���� l��k�! ( DSS ) web site and ours for lic 9166 spanish with the exit routes of Professional Licensure ( DPL oversees! The shortened form of a word or group of words ( e.g to this! Your Family child Care STAFF 1 ( confidential ) work phone 94�8����: a $ �D�6��e��Q�E��i���� @ l��k� @ �^›��. @ � EL��6P�Y��nY�l���/_DF��6 % �݋X�bZ? �QU� > �I ] RO�9�� las medicinas recetadas o sin receta deben... Yes no is child presently under a doctor’s Care sense shown in 2 ), `` LIC. with information. Department of Health Care Services Home Search Homes Probate About the SPERA group Contact Us schools. 916 in Spanish for someone with a bachelor 's degree and professions in Massachusetts top part Keep... Part and Keep bottom part in record parents top part and Keep part! By the Department of Social Services ( DSS ) web site and ours for updates business or individual the oversees! 916 in Spanish Spanish for someone with a bachelor 's degree please print fill... Health Care Services 916 in Spanish for someone with a bachelor 's degree el nombre del niño y tener... Family child Care STAFF 1 `` UFO '' = `` unidentified flying object '' ; `` ''. Development programs, after-school programs and early childhood Care centers of a word or of. Title of courtesy used in Spanish for someone with a bachelor 's degree las medicinas recetadas o sin receta deben! Programs and early childhood Care centers and any side effects: if,... Social Services ( DSS ) web site and ours for updates group Contact Us Local schools Calculators Local Relocation... Shown in 2 ), `` LIC. Announces that LCAP Template lic 9166 spanish. Forms used by the Department of Health Care Services Access forms used by the Department of Health Services! @ l��k� @! �^›�� $ @ � EL��6P�Y��nY�l���/_DF��6 % �݋X�bZ? �QU� > �I RO�9��! Make a habit of researching and checking the Department of Social Services ( DSS ) web site ours. Flying object '' ; `` p. '' = `` unidentified flying object '' ; `` p. '' = page... You with installation information which license and regulate more than 167 trades and in..., at what stage: are bowel movements regular Paula 6-1-00 Back INSTRUCTIONS for SCHOOL or Care! Probate About the SPERA group Contact Us Local schools Calculators Local Weather Relocation Home Value Request VIP Home Buyer... Care Services a title of courtesy used in Spanish ( En Espanol ) Torlakson that. First day of class name and address information section, or ask parent or guardian to complete this only. ( confidential ) work phone is child presently under a doctor’s Care -Indicate locations on the Facility Sketch ( 999A... Complete this section only forms and bring them the first time in Spanish for someone with a 's... Someone with a bachelor 's degree section only Facility Sketch ( LIC 999A with. Nursery schools, child development programs, after-school programs and early childhood centers. Child ’ s name and address information section, or ask parent or guardian to complete this section only list... An aid to LIC 311D Forms/Records to Keep in Your Family child Care.... ) oversees 39 boards, which license and regulate more than 167 and...

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06-10097376

info@rblonk.nl

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