Form LIC9187 Child Care Client Death Report - California

Form LIC9187 Child Care Client Death Report - California

What Is Form LIC9187?

This is a legal form that was released by the California Department of Social Services - a government authority operating within California. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is the purpose of Form LIC9187?
A: Form LIC9187 is used to report the death of a child in a licensed child care facility in California.

Q: Who is required to complete Form LIC9187?
A: The licensed child care facility is responsible for completing Form LIC9187 when a child dies while in their care.

Q: When should Form LIC9187 be completed?
A: Form LIC9187 should be completed immediately after the child's death and submitted to the California Department of Social Services within 24 hours.

Q: What information is needed to complete Form LIC9187?
A: The form requires information such as the child's name, age, date and time of death, cause of death, and details about the circumstances surrounding the death.

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Form Details:

  • Released on July 1, 2000;
  • The latest edition provided by the California Department of Social Services;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;

Download a fillable version of Form LIC9187 by clicking the link below or browse more documents and templates provided by the California Department of Social Services.

Download Form LIC9187 Child Care Client Death Report - California

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  • Form LIC9187 Child Care Client Death Report - California, Page 1
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