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  • Community Care Licensing - California Dept. of Social Services
    Welcome to the Community Care Licensing Division We serve the most vulnerable people of California and our mission is to promote the health, safety, and quality of life of each person in community care through the administration of an effective and collaborative regulatory enforcement system
  • Forms Brochures - California Dept. of Social Services
    The California Department of Social Services (CDSS) Privacy Notice on Collection covers our practices regarding personal information collected when completing applications and forms (online or hardcopy) for our various programs
  • Forms and Publications (I-L) - California Dept. of Social Services
    LIC 311D (2 22) - Forms Records To Keep In Your Family Child Care Home LIC 311E (4 05) - Records To Be Maintained At The Facility - Small Family Home And Foster Family Home LIC 311F (4 05) - Records To Be Maintained At The Facility - Residential Care Facility For The Elderly LIC 313 (12 01) - Evidence Of Program Consultant
  • Forms - Alphabetic List
    Back to Top Accessibility Accessibility Certification Conditions of Use Contact Us Get Free Reader Notice on Collection Privacy Policy
  • Forms - by Program - California Dept. of Social Services
    Multiple Programs (forms common to more than one program) Notice of Action: ( NA ) You may also want to search ( Temp ) for additional Notices of Action Notice of Action Documents: ( M ) These documents are in Word format only Temporary Forms: Search ( Temp ) for additional program forms Other Miscellaneous Forms: ( GEN ) Publications
  • Child Care Licensing - California Dept. of Social Services
    Manage pages within the site Child Care Licensing Program Mission The core mission of the Child Care Licensing Program is to ensure the health and safety of children in care The Child Care Licensing Program strives to provide preventive, protective, and quality services to children in care by ensuring that licensed facilities meet established health and safety standards through monitoring
  • Certification Forms - California Dept. of Social Services
    Vendor Forms: LIC 9141 – Vendor Application Renewal – An individual, for profit or nonprofit business or governmental entity submits this form to request ACB approval to become a vendor and offer initial or continuing education courses for facility administrators
  • Adult Care Licensing - California Dept. of Social Services
    Mission The core mission of the Adult Care Licensing Program is to optimize the health, safety, and quality of life of adults in community care facilities through the administration of an effective, collaborative, and regulatory enforcement system that emphasizes harm prevention and proper and timely compliance
  • Forms and Publications (Q-T) - California Dept. of Social Services
    R Forms RAD 03 (2 21) – Suspected Unemployment Insurance Fraud And identity Theft Information RAD 04 (12 21) – Work Participation Rate Request for Policy Interpretation RCA 43 (5 03) - Refugee Cash Assistance (RCA) Notice Of A Participation Problem
  • Laws and Regulations - California Dept. of Social Services
    CCLD Complaint Hotline If you see something, let us know! To file a complaint regarding a state licensed community care facility, child care facility, or home care organization, visit our Complaint Hotline Page for contact information and more





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