Child in Care Statement Receipt - CCL-3900 - Word-2026

1. Click ‘Get Form’ to open the Child in Care Statement Receipt - CCL-3900 in our editor.
2. Begin by entering the child(ren)’s name(s) in the designated field at the top of the form. Ensure you include the last name, first name, and middle initial for accuracy.
3. In Section 1, carefully read through each rule and policy. Initial next to each statement to confirm receipt and understanding. This section is crucial for compliance with licensing requirements.
4. Proceed to Section 2, where you will need to provide health status information. Indicate whether your child(ren) has any health conditions that may pose risks and complete the immunization status section as required.
5. In Section 3, check applicable boxes regarding notices about immunizations, pets, firearms, and other relevant information. This ensures transparency between you and the licensee.
6. Finally, complete Section 4 by certifying your understanding of the food agreement if applicable. Sign and date where indicated to finalize the document.

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