LIC 995 Notification of Parents' Rights
State of California – Health and Human Services Agency. California Department of Social Services – Community Care Licensing DivisionLIC 995 (9/08)
As a Parent/Authorized Representative, you have the right to:
NOTE: CALIFORNIA STATE LAW PROVIDES THAT THE LICENSEE MAY DENY ACCESS TO THE CHILD CARE CENTER TO A PARENT/AUTHORIZED REPRESENTATIVE IF THE BEHAVIOR OF THE PARENT/AUTHORIZED REPRESENTATIVE POSES A RISK TO CHILDREN IN CARE.
For the Department of Justice “Registered Sex Offender”database, go to www.meganslaw.ca.gov
I, the parent/authorized representative of
have received a copy of the “CHILD CARE CENTER NOTIFICATION OF PARENTS’ RIGHTS” and the CAREGIVER BACKGROUND CHECK PROCESS form from the licensee.Name of Child Care Center: Technique Adventure & Activity center
NOTE: This Acknowledgement must be kept in child’s file and a copy of the Notification given to parent/authorized representative.
For the Department of Justice “Registered Sex Offender” database go to www.meganslaw.ca.gov
Leave this empty:
Your legal name
Your email address
Signed by Kathy Olvera
Signed On: January 9, 2021
If you have questions about the contents of this document, you can email the document owner.
Document Name: LIC 995 Notification of Parents' Rights
Agree & Sign