Last modified: 8/20/2013 4:58 PM
Listed are forms that are required for the foster adoption application. Please download and complete the forms. If you have questions feel free to contact our recruitment staff at 408-299-KIDS for assistance. Also listed below are links to the California State Department of Community Care Licensing. There you will find more information on licensing regulations for the state of California.
Applicant Information LIC 215
This form must be completed by all applicants for a facility license, (i.e., all individuals, each partner in a partnership, or chief executive officer or authorized representative in a corporation.) If more space is required, attach additional sheet.
Child Abuse Central Index Check for County Licensed Facilities LIC 198
We are required by law to check the names of all persons who apply for a license or seek employment in a child day care or residential facility caring for children against the Child Abuse Central Index. Persons required to submit fingerprints for a child care facility (day or residential) must also fill out this form. Please complete the information below. The Licensee is responsible for submitting fingerprints and this form along with the Child Abuse Central Index Check processing fee to the county licensing office.
Facility Sketch Floor Plan LIC999
Applicants are required to provide a sketch of the floor plan of the home or facility and outside yard. The floor sketch must label rooms such as the kitchen, bath, living room, etc. Circle the names of the rooms that will be used by staff/residents/clients/children. Door and window exits from the rooms must be shown in case of an emergency (see Emergency Disaster Plan). Show room sizes (e.g. 8.5 x 12). Keep close to scale.
Health Screening Report - Facility Personnel LIC503
All personnel, including applicant, licensee or employed staff of Residential Care Facilities for the Elderly, Community Care or Child Care Facilities must demonstrate that their health condition allows them to perform the type of work required. This health appraisal is to be completed by or under the direction of a physician.
Live Scan Referral SCZ152
use this form for caregivers, additional adults in their homes or adults associated with a relative's or NREM's home, and official volunteers.
Personal References Request
To complete your Foster Care Application/Adoptions Homestudy Application, we are requesting that you provide four (4) personal references.
The Personal Rights of Foster Children SC43
This document is a excerpt from the California Code of Regulations covering the personal rights of foster children including: Foster Family Homes Regulations, Section 89372; Group Homes Regulations, Section 84072; Small Family Homes Regulations, Section 83072.