Blank Lic 279 PDF Template

Frequently Asked Questions about the LIC 279 Form

1. What is the LIC 279 form?

   The LIC 279 form is an application used by individuals in California who wish to operate a family child care home. This form is required by the California Department of Social Services, Community Care Licensing Division. It gathers detailed information about the applicant(s), the home where the child care will be provided, and the type of care (such as the number of children and ages served). This form is the first step in ensuring that child care homes meet the state's health and safety standards.

2. Who needs to fill out the LIC 279 form?

   Any individual or individuals planning to provide child care services in their home in California must complete the LIC 279 form. Applicants must be over 18 years old and live in the home intended for child care. The form applies to those seeking a new license, a capacity change, a location change, or an update to their current license.

3. What information do you need to provide in the LIC 279 form?

   • Type of application (new, capacity change, location change, update)
   • Applicant(s) information, including if they are over 18 years old
   • Home address and mailing address if different
   • Directions to the home and a list of counties the applicant has resided in if they haven’t lived in their current county for the past two years
   • Information on any current or past licenses or certifications to provide care
   • Details about other adults and children living in the home
   • Proposed type of license (small or large home) including the ages to be served and operating days and hours
   • Applicant’s responsibilities and certifications about compliance with laws and regulations
   • A perjury statement to affirm the truthfulness of the information provided

4. How do you submit the LIC 279 form?

   After filling out the LIC 279 form, including signing and dating all documents in ink, you must enclose the required application/licensing fee and submit the packet to the California Department of Social Services, Community Care Licensing Division. It's crucial to provide all requested information accurately to avoid delays in the application process. If you need assistance or have questions, the Department provides resources and guidance for completing the form correctly.

Filling out the Application for a Family Child Care Home License (LIC 279) requires attention to detail to avoid common mistakes. Here is a list of eight errors applicants often make:

1. Not selecting the correct type of application. Applicants sometimes overlook indicating whether they are submitting a new application, requesting a capacity change, a location change, or simply updating their information.
2. Omitting the applicant's age verification. It is mandatory to confirm that all applicants are over 18 years old, a requirement for providing child care in their own home.
3. Inaccuracies in the home address section. This is critical as it is the address of the home where child care will be provided and subject to inspection for health and safety standards.
4. Failure to list all counties of residence if the applicant has not lived in the current county for the past two years. This oversight can affect the background check process.
5. Neglecting to provide a separate mailing address if it is different from the home address. This can result in missed communications from the Licensing Agency.
6. Incorrectly reporting or omitting the status of any previous or pending licenses or certifications for providing care. This information is crucial for understanding an applicant's history and qualifications.
7. Forgetting to list or incorrectly listing other adults living in the home. Accurate information is required for all adult residents for background checks and safety evaluations.
8. Omission of the signature and date under the perjury statement. This is a legal acknowledgment that the information provided is accurate, and forgetting to sign can lead to the application being deemed incomplete.

Attention to these details is crucial for a successful application process. Ensuring accuracy and completeness in filling out the LIC 279 form helps expedite the licensing process.

When applying for a Family Child Care Home License using the LIC 279 form, applicants often need to gather and submit additional forms and documents as part of the application process. These documents are essential for ensuring that all the necessary information is thoroughly reviewed by the licensing agency to meet state requirements for operating a family child care home.

• LIC 279B - Current Children in Your Home: This form lists all children currently living in the applicant's home, including their names, dates of birth, gender, and relationship to the applicant. It's part of the confidential portion of the facility file.
• LIC 9151 - Property Owner/Landlord Notification: This document is a notification sent to the property owner or landlord to inform them that the applicant plans to operate a Family Child Care Home on the premises.
• LIC 9149 - Property Owner/Landlord Consent Form: This form is required when the applicant plans to expand the capacity of their Family Child Care Home. It serves as written consent from the property owner or landlord.
• LIC 9108 - Child Abuse Reporting Requirements: Applicants must understand and comply with the requirements for reporting known or suspected child abuse. This form outlines these obligations.
• LIC 508 - Criminal Record Statement: Each applicant and other adult living in the home must complete this form, which discloses any criminal history.
• LIC 503 - Health Screening Report: A health screening and TB test result report for the applicant and any adults living in the home to ensure they are free of infectious diseases and physically capable of caring for children.
• Emergency Disaster Plan: Although not a standard form like the LIC documents, applicants are usually required to submit an emergency disaster plan for their home, specifying evacuation routes and emergency procedures.
• Fire Safety Inspection Report: A report from the local fire department confirming that the home meets fire safety standards, including the installation of smoke detectors and a fire extinguisher approved by the State Fire Marshal.

Collectively, these forms and documents paint a comprehensive picture of the applicant's eligibility and preparedness to provide a safe and nurturing environment for children. Each document serves a specific purpose in the application process, ensuring that all aspects of home safety, health, and legal compliance are addressed.

• Business License Application Forms: Similar to the LIC 279 form, business license applications also require detailed information about the applicant, including the location and purpose of the business. Both forms involve declaring the premises to be used for specific purposes and may require notifying and acquiring consent from property owners.

• Foster Home Licensing Applications: These forms share similarities with the LIC 279 form in that they both involve providing care within a home environment and require information about all individuals living in the home. Additionally, they necessitate background checks and adherence to specific safety and health standards mandated by state agencies.

• Child Adoption Forms: Adoption forms, like the LIC 279, require applicants to provide detailed personal information, history of residence, and specify the capacity in which they are applying (e.g., to adopt a child). They also involve assessments to ensure the home environment is suitable for children, akin to the LIC 279's requirement for fire safety equipment and adherence to caregiving standards.

• Zoning and Land Use Permits: These permits involve notifying and sometimes obtaining consent from property owners for specific uses, similar to the LIC 279 form’s requirements for applicants to inform and gain consent from property owners or landlords when operating a family child care home. They ensure the proposed use is in compliance with local land use and zoning regulations.

• Building Permit Applications: Building permits require detailed plans and specifications of the proposed project, including changes to the existing structure, similar to how the LIC 279 form requires approval from the licensing agency for changes to the licensed space. Both forms necessitate adherence to safety and health standards.

• Professional Licensing Applications: These applications, while covering a broad range of professions, share the LIC 279 form's emphasis on applicant qualifications, history of licensure, and compliance with state regulations. They often require information on the applicant's background, education, and sometimes previous licenses or certifications held, similar to the LIC 279’s section on licensing status.

When completing the LIC 279 form for a Family Child Care Home License, it’s crucial to approach it with accuracy and attention to detail. Below are key do’s and don’ts that applicants should keep in mind:

• Fill out the form using a typewriter or print clearly in ink to ensure that all information is legible and easy to understand.
• Check the appropriate boxes for the type of application you're making, such as a New Application, Capacity Change, Location Change, or an Update.
• Ensure you list all applicants over 18 years of age involved in providing child care in your home.
• Provide complete and accurate information for your home address, including a phone number where you can be easily reached.
• Include directions to your home and, if possible, attach a sketch or map to assist in the location finding process.
• Disclose any licenses or certifications you currently hold or have previously held for child or adult care.
• Sign and date the form, ensuring that all attached documents are also signed and dated where required.

• Forget to check the age eligibility box for each applicant, confirming they are over 18 years old.
• Leave out the mailing address if it's different from your home address. Clearly specify where you wish to receive mail.
• Omit any details about other adults living in the home. Every person, excluding those under 18 years of age, should be listed.
• Ignore the section on children currently in your home. This information is crucial and must be filled out on form LIC 279B.
• Neglect to specify the type of license you are applying for, whether it's for a small or large home, and the ages of children you plan to serve.
• Fail to acknowledge and confirm your understanding of applicant/licensee responsibilities, including compliance with laws and notification requirements.
• Leave the perjury statement unsigned. Your application is incomplete without your signature, certifying that all provided information is true.

By following these guidelines, applicants can improve the quality of their submission and facilitate a smoother application process for their Family Child Care Home License.

There are several misconceptions about the LIC 279 form, which is used in California for the application for a family child care home license. Understanding these misconceptions is crucial for applicants to ensure they accurately complete and submit their forms. Here are seven common misunderstandings:

• The form is only for first-time applicants. This is incorrect. The LIC 279 form caters to various purposes, including new applications, capacity changes, location changes, and updates to existing licenses.

• Email address is a mandatory field. On the contrary, the email address field is not required to complete the LIC 279 form. Applicants have the option to provide this information but are not obliged to.

• Only children living in the home need to be listed on the application. This misunderstanding could lead to incomplete applications. Applicants must also list all other adults living in the home, excluding those under 18 years of age, to provide a full overview of the household composition.

• An applicant must own the home to apply. Ownership of the home is not a prerequisite for application. Applicants can lease or rent their home, but if they plan to increase the capacity of their child care, they must provide written consent from the property owner or landlord.

• You can only apply for a small or large home license. The LIC 279 form does allow applicants to specify the type of license they are applying for, including the capacity and age range of children they plan to serve, providing flexibility in the services they intend to offer.

• Applicants do not need to disclose previous licenses or certifications for care facilities. Applicants are indeed required to disclose any current or previous licenses or certifications they have held for providing care. This includes details of the licensing agency, type of license, and dates of certification.

• The form cannot be submitted with additional attachments. Actually, if there is not enough space on the form to provide all the necessary information, the application can and should be submitted with additional paper attached. This ensures that the Department of Social Services receives all the relevant information needed to process the application.

Correcting these misconceptions is critical for applicants to navigate the licensing process effectively and to ensure the wellbeing of children in their care.

Filling out the LIC 279 form is a significant first step towards establishing a family child care home in California. Here are key takeaways to ensure the process is handled smoothly and accurately:

• Be thorough and accurate: It's critical to type or print clearly when completing the form to prevent any delays in the licensing process due to illegible handwriting.
• Understand the type of application: Knowing whether you're filing a New Application, Capacity Change, Location Change, or simply an Update can streamline the process and ensure that you provide all the necessary information for your specific request.
• Applicant eligibility: All applicants must be at least 18 years old and reside in the home to be licensed, highlighting the importance of personal responsibility in the care environment.
• Address details matter: Your home address is not just where you live; it's where you'll be providing care. It's also where the Licensing Agency will conduct inspections, so accuracy is essential.
• Communication is key: Providing a current phone number and, though not required, an email address ensures the Licensing Agency can contact you efficiently.
• Disclosure of past licenses: Being open about any current or previous licenses or certifications you've held for child or adult care facilities is mandatory, as it gives the Licensing Agency insight into your caregiving background.
• Include all household members: Listing other adults in your home is necessary to identify everyone living in the potential care environment, enhancing the safety and well-being of the children to be served.
• Clarify your care capacity: Deciding and detailing whether you aim to operate a Small or Large Family Child Care Home informs the Licensing Agency of the scope of your care services.
• Responsibilities of the applicant/licensee: Acknowledging your obligations—from living in the home and maintaining service levels to complying with fire safety and reporting requirements—is crucial for a successful application.
• The perjury statement: Signing the application under penalty of perjury means that you are swearing the information provided is true. This underscores the seriousness of the application process and the legal implications of providing false information.

Approaching the LIC 279 form with detail and diligence can pave the way for a smoother licensing process, laying a strong foundation for your family child care home. Remember to review each section carefully, ensure all responses are thorough and accurate, and reach out to the California Department of Social Services with any questions to prevent unnecessary delays or complications.