Get Ca Lic 9040 2005-2025

Filling out the California Child Care Facility Roster (CA LIC 9040) is an essential task for maintaining compliance in child care facilities. This guide provides clear and user-friendly instructions to help you complete the form accurately and efficiently online.

Follow the steps to complete the CA LIC 9040 form effectively.

1. Click ‘Get Form’ button to obtain the form and open it in your preferred editor.
2. Enter the facility name in the designated field. Ensure that the name matches the registered name of your child care facility.
3. Input the facility license number accurately in the corresponding field. This information is crucial for identification and compliance.
4. For each child under your care, provide their full name and birthdate. This ensures proper record-keeping and helps in emergency situations.
5. Fill in the home address of each child, making sure to provide complete and accurate information.
6. List the names of the parent(s) or guardian(s) associated with each child, and include their daytime phone numbers for contact.
7. Record the name and phone number of each child's physician. This is important for health-related emergencies.
8. Document the date of enrollment for each child in your care to keep historical records.
9. If a child leaves the facility, make sure to provide the date they left in the relevant section to keep the roster current.
10. Once all fields have been filled out, review the information for accuracy. After confirming everything is correct, you can save changes, download, print, or share the form as needed.

Complete your CA LIC 9040 online today to ensure compliance with state regulations and to maintain an accurate record of children in your care.