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;
  • Fill out the form in our online filing application.

Download a fillable version of Form LIC9187 by clicking the link below{class="scroll_to"} 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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