LICENSING FORMS

You may either download and email the completed packet to littlebloomacademy@gmail.com OR print it out and bring it on your child’s first day, along with the enrollment packet, tuition payment, and the $100 non-refundable enrollment fee.

Please ensure that ALL forms are signed and dated, even if there is no designated signature line—simply sign and date the bottom of each page. Incomplete or unsigned forms will be returned and may delay your child’s enrollment.

Identification and Emergency Information: LIC 700

Affidavit Regarding Liability Insurance: LIC 282

Consent for Emergency Medical Treatment: LIC 627

Child’s Pre admission Health History: LIC 702

Family Child Care Consumer Awareness Information: LIC 9212

Important Information for parents: LIC 995E

Notification of Parents' Rights: LIC 995A

Caregiver Background Check Process: LIC 995E

Acknowledgement of Receipt of Licensing Reports: LIC 9224

THIS IS THE ONLY FORM THAT MUST BE PRINTED ON BLUE COPY PAPER (If you do not have blue paper, we will provide a form for you)

California School Immunization Record: PM 286

INFANTS (Children Under 2)

Individual Infant Sleeping Plan: LIC 9227

LICENSING FORMS: Text