California lic 624b 2026

1. Click ‘Get Form’ to open the California LIC 624B in the editor.
2. Begin by entering the facility license number as shown on your license in the designated field.
3. Next, input the licensee's name exactly as it appears on the license.
4. Fill in the facility name and address, ensuring all details are accurate for proper identification.
5. List the names of any children involved in the incident, along with their birth dates or ages.
6. Indicate each child's sex by selecting 'M' for Male or 'F' for Female.
7. Document the admission date of each child into your care.
8. Record the primary language spoken by each child or their parents.
9. Enter the date and time when the incident occurred, followed by checking all applicable events that need reporting.
10. Provide a detailed description of what happened, including any injuries and preventive measures taken for future incidents.

Start using our platform today to fill out your California LIC 624B form easily and efficiently!