Get OK DHS 07LC089E 2008
D to the licensing specialist. Facility requesting waiver Facility name Mailing address: street or P.O. Box City License number County K8 State Zip Name of person requesting waiver Position Owner Director Person for whom waiver is requested First name Middle name Last name Position or relationship Live in facility? Yes No The person the request is being made for will NOT be employed, work with children, or be present in the facility when children are in care, until a decision has bee.
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