Es. Any owner, operator, current or prospective employee, or volunteer of a child care facility licensed by the department who knowingly falsifies the information on the State Central Registry Disclosure Form shall be guilty of a misdemeanor offense and shall be fined not more than five hundred dollars, or imprisoned for not more than six months, or both. R.S. 46:1414.1.C. This form shall be maintained by the owner/operator of the licensed facility in accordance with current licensing standards .
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How to fill out the LA SCR-1 LIC online
The LA SCR-1 LIC form is essential for individuals involved in child care facilities licensed by the Louisiana Department of Children and Family Services. This guide provides step-by-step instructions on how to properly complete the form online.
Follow the steps to fill out the LA SCR-1 LIC form accurately.
- Click the ‘Get Form’ button to obtain the LA SCR-1 LIC and open it in your preferred online document editor.
- Begin by entering the name of the licensed facility in the designated field. Ensure that the name is printed or typed clearly to avoid any misunderstandings.
- Next, provide the physical address of the licensed facility. This address should include the street number, street name, city, state, and zip code.
- In the 'License #' section, input the license number associated with the facility. This is crucial for validating the facility's status.
- Enter your name or the name of the individual applicant as requested, ensuring clarity in your entry.
- Fill in your date of birth in the specified format. This is necessary for identification purposes.
- Input your Social Security number in the designated field to verify your identity.
- If applicable, provide your maiden name, previous names, or any other names you have used. This information helps in the background check process.
- Indicate your race in the appropriate section as requested by the form.
- Specify your sex in the provided field.
- Include your current street address, along with the city, state, and zip code.
- If you have moved recently, provide your most recent previous address and the city, state, and zip code where it is located.
- Enter your current home phone number and current cell phone number, if available.
- Next, answer whether you are currently recorded as a perpetrator on the State Central Registry by checking 'My name is' or 'is not.'
- Indicate if you have been determined to have a justified finding of child abuse or neglect since your last Risk Evaluation Panel finding.
- Finally, confirm that all the information provided is true and complete by signing and dating the form. Ensure that a representative from the licensed facility also signs and dates the form.
Complete your LA SCR-1 LIC form online today to ensure compliance and maintain your eligibility in child care facilities.
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