Lic 279 2025

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4.9 out of 5

29 votes

The document is an application form for a Family Child Care Home License from the California Department of Social Services. It outlines the types of applications (new, capacity change, location change, update), provides instructions for completing the application, and details the responsibilities of applicants. The form requires personal information about the applicants, their home address, other adults and children living in the home, and compliance with licensing regulations. It emphasizes the importance of truthful declarations under penalty of perjury.

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Click ‘Get Form’ to open the LIC 279 application in the editor.
Begin by selecting the type of application you are submitting: New Application, Capacity Change, Location Change, or Update. Make sure to check the appropriate box.
Fill in your name and confirm that you are over 18 years old. Provide your home address where care will be provided, including city, county, state, and ZIP code.
If applicable, list any other counties you've lived in during the past two years. This is important for licensing verification.
Complete your mailing address if it differs from your home address. If they are the same, simply write 'Same'.
Indicate whether you have ever been licensed or certified for any type of facility to care for children or adults. Provide details if applicable.
List all adults living in your home who are not applicants. Remember not to include anyone under 18 years of age.
Complete the LIC 279B form for current children in your home by providing their names and relevant details.
Specify the type of license you are applying for based on the number of children you plan to serve and their ages.
Review and acknowledge your responsibilities as an applicant by checking each statement confirming compliance with licensing laws.
Finally, sign and date the application under penalty of perjury to affirm that all information provided is accurate.

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Versions	Form popularity	Fillable & printable
2009	4.9 Satisfied (29 Votes)

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