LICENSING FORMS

Download and email to littlebloomacademy@gmail.com OR Print out and bring packet on first day of school along with enrollment packet and tuition fees along with enrollment fee of $100.

Please make sure ALL forms are SIGNED and DATED (even the forms without a designated area to sign, just sign and date the bottom area please) or they will be returned to you.

Identification and Emergency Information: LIC 700

Child’s Preadmission Health History: LIC 702

Personal Right's: LIC 613A

If you See Something: PUB 475

Family Child Care Consumer Awareness Information: LIC 9212

Important Information for parents: LIC 995E

Notification of Parents' Rights: LIC 995A

Consent for Emergency Medical Treatment: LIC 627

Acknowledgement of Receipt of Licensing Reports: LIC 9224

Caregiver Background Check Process: LIC 995E

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