Enrollment

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ENROLLMENT

Forms

IMMUNIZATION RECORD

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IDENTIFICATION & EMERGENCY INFORMATION

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CONSENT FOR EMERGENCY MEDICAL TREATMENT

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CHILD’S PREADMISSION HEALTH HISTORY

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Three young girls posing for a picture.
Two young girls are playing in a swing.
A group of young boys wearing colorful ponchos.
A group of children standing next to each other.
A group of children sitting on the floor with books.
A group of children playing with toys on tables.
A group of children sitting at a table with drinks.
A little boy holding a pumpkin in his hands.
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Acknowledgements

Please download each file and print them. Make sure to bring each acknowledgment reciepts with your signature.

NOTIFICATION OF PARENT'S RIGHTS

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AFFIDAVIT REGARDING LIABILITY INSURANCE FOR FAMILY CHILD CARE HOME

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PARENT NOTIFICATION ADDITIONAL CHILDREN IN CARE

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FAMILY CHILD CARE CONSUMER AWARENESS INFORMATION

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CAREGIVER BACKGROUND CHECK PROCESS

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ACKNOWLEDGEMENT OF RECEIPT OF LICENSING REPORTS

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PHONE

510-938-5060

EMAIL

[email protected]​

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Newark's Lake, California