Joey's House
Family Child Care

These are the forms and notifications required by this facility to recieve services. Feel free to print them out and bring them to your admission interview.

Please Note: No services will be given until all forms are completed and on file with this facility.
NO EXCEPTIONS
Application and Emergency Forms
Admission_Application.zip
Admission_Application.zip
This is a Microsoft Works Spreadsheet Document and may not open for some users.
The forms below are required by the State of California-Community Care Licensing Division. They are in the PDF format and the Acrobat Reader will be required to view/print them.

Need the acrobat Reader? Click the link below and you will be taken to the Adobe website for a free download of the Acrobat Reader v8.1

Get Adobe Acrobat v8.1
Lic_702-_Health_History.zip
Lic_702-_Health_History.zip
Lic_700-ID_and_Emergency_Information.zip
Lic_700-ID_and_Emergency_Information.zip
Lic995A-Parent_s_Rights.zip
Lic995A-Parent_s_Rights.zip
Injury_Treatment_Substance_Authorization.zip
Injury_Treatment_Substance_Authorization.zip
Lic_627-Consent_for_Emergency_Treatment.zip
Lic_627-Consent_for_Emergency_Treatment.zip
Lic995E-Background_Check_Information.zip
Lic995E-Background_Check_Information.zip
Lic_9150-Parent_Notification.zip
Lic_9150-Parent_Notification.zip
These are Microsoft Word Documents and may not open for some users.
Contract_for_Service_2007.zip
Contract_for_Service_2007.zip
In addition to the above forms, a current copy of your child's immunization record will be required to participate in tthis program.

Please email me or call if you need any assistance in completing the forms or have any questions regarding the services of Joey's house.

Email Machelle