Get Lic 279

Completing the Lic 279, a request for a license to operate a children's care home, is an essential step in ensuring compliance with state regulations. This guide provides a detailed, user-friendly approach to help you fill out the form accurately and efficiently.

Follow the steps to complete your Lic 279 application effectively.

1. Press the ‘Get Form’ button to download the Lic 279 form, allowing you to access and complete it online.
2. In section 1, select the type of application you are submitting, whether it is a new application, a change in capacity, a location change, or an update, by marking the appropriate checkbox.
3. Provide the applicant's full name in section 2, ensuring to include the first name, last name, and confirm that all applicants are 18 years of age or older by marking 'Yes' or 'No' as applicable.
4. In section 3a, enter your home address where the childcare services will be provided, including the city, state, and zip code, along with your primary phone number.
5. If you have not lived in the current county for the past two years, detail your previous counties of residence in section 3b.
6. Fill out section 4 with your mailing address if it differs from your home address. If the same, indicate ‘same.’
7. In section 5, provide clear directions to your home, and consider attaching a map or diagram for clarity.
8. For section 6, disclose any current or past licenses or certifications regarding childcare, including details of the issuing authority and contact information.
9. List all adults living in the home in section 7, excluding applicants; if needed, attach extra sheets for additional names.
10. Use section 8 to complete the LIC 279B form for all minors currently residing in your household, detailing their names and relationships.
11. Indicate the type of license you are applying for in section 9 and provide information regarding the number of children to be cared for and their operational hours.
12. In section 10, certify your responsibilities as the applicant/licensee by confirming compliance with specific regulations and safety requirements.
13. Conclude in section 11 by signing and dating the form, affirming your statements are true and accurate according to your knowledge and understanding.

Complete your Lic 279 form online today for a smoother application process.