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Get Administrator And Program Director Information - California ... - Cdph Ca
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How to fill out the Administrator and Program Director Information - California - Cdph Ca online
Filling out the Administrator and Program Director Information form is essential for gaining licensure approval in California. This guide will provide clear instructions on how to accurately complete each section of the form to ensure your application is successful.
Follow the steps to successfully complete the form online.
- Press the ‘Get Form’ button to access the form and open it in your preferred editing interface.
- Enter the licensee name and center name in the designated fields. Clearly indicate your position by selecting either Administrator or Program Director.
- Provide your identifying information, including your name, birthdate, address, sex, any previously used names, social security number, and driver's license number. Ensure all information is typed or printed clearly.
- Fill out the education section by providing the name and location of the college attended, course of study, years completed, and degree obtained.
- In the civil record section, answer the questions regarding any past convictions or judgments. If applicable, attach an explanatory sheet that details the circumstances.
- Provide references who can vouch for your ability to provide care or manage a care facility. List their names, addresses, and your relationship to them.
- Complete the business experience section by noting if you have owned or operated any business. List details regarding the type of business and your role.
- Provide your employment summary for the last ten years. Attach a resume that includes the required details such as dates, employer names, basic duties, and reasons for leaving.
- Lastly, review the entire form for accuracy. Once completed, you can save changes, download, and print the form or share it as necessary.
Complete your Administrator and Program Director Information form online today to ensure timely processing of your application.
The current director of the California Department of Public Health (CDPH) is Dr. Tomás J. Aragón. He leads the department in its mission to protect and enhance the health of Californians. For the latest Administrator And Program Director Information - California ... - Cdph Ca, you can check CDPH's official updates and announcements.
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