California Code § 102419(d): Required Enrollment Forms
What Is California Code § 102419(d): Required Enrollment Forms?
California Code § 102419(d)
At the time of acceptance of each child into care, the licensee shall provide the child's parent or authorized representative with a copy of the notice Family Child Care Home Notification of Parent's Rights, LIC 995A (8/06), the Caregiver Background Check Process, LIC 995E (6/05), and the Family child Care Consumer Awareness Information, LIC 9212 (10/05). REPRESENTATIVE’S RIGHTS
💬What Providers Tell Us
Based on community experience — not official guidance
Inspectors pull enrollment files at random and check for all three forms: LIC 995A, LIC 995E, and LIC 9212. They don't just look for the forms. They verify the version dates printed on each one match the current version. If you're using a 995A from 2004 instead of the 8/06 version, that's a deficiency even though you technically gave the parent a copy. Print fresh forms from the CDSS website every six months and swap out your enrollment packets. Keep a signed acknowledgment sheet in each child's file showing the parent received all three on the enrollment date. That signature is what saves you during a dispute.
Source: California CCLD inspection records | Data as of Apr 6, 2026. Last updated April 6, 2026.
3 facilities were cited for this in the last 90 days.
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What Other Providers Do for Required Enrollment Forms
Common practices shared by providers. Confirm requirements with your licensing analyst.
✓ Common Practices
❌ Common Mistakes
- Providing two of the three required forms and missing one, usually the LIC 9212 Consumer Awareness Information. Providers remember the Parent's Rights notice because parents ask about it, but the Consumer Awareness form gets overlooked because nobody requests it.
- Using outdated form versions. The forms have specific revision dates (LIC 995A dated 8/06, LIC 995E dated 6/05, LIC 9212 dated 10/05), and inspectors check those dates in the footer. Photocopies from years ago may be the wrong version.
- Not having a parent signature confirming receipt. Without a signed acknowledgment, you have no proof the forms were given, and the inspector documents it as not provided.
- Giving forms to a nanny or babysitter who drops the child off instead of the parent or authorized representative named on file. The regulation specifies the parent or authorized representative, and an unauthorized pickup person doesn't qualify.
- Adding forms to the file after enrollment when an inspector flags the gap. Backdating paperwork is a separate violation and inspectors can tell when forms were recently printed versus stored in a file for months.
What's Being Cited in Each Region Over the Past 90 Days
Based on facility inspection reports filed with California's Community Care Licensing Division, here's how this citation appears across different regions in the past 90 days.
Monterey County
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San Diego County
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Los Angeles County
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Data updated weekly from CCLD public records. Last update: 4/6/2026
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A single Type A citation can cost $150-$500+ in civil penalties, not counting the follow-up inspection it triggers.
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Frequently Asked Questions
Answers based on public CCLD data and regulation text. May not reflect recent changes.
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Related Violations
This information is educational and does not constitute legal advice. Consult a licensed childcare compliance consultant for guidance specific to your facility. Citation data is sourced from California Community Care Licensing Division public records and is refreshed regularly.