California Code § 102419(d): Required Enrollment Forms

📋Type A Violation🏢Affects: Family Child Care Homes

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

💡Insider's Tips

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.

facilities cited recently

That's 1 in 10000 facilities

counties affected

most common citation

📉

Decreasing

Last 90 days vs. previous 90 days

6 facilities (was 14)8 facilities

Source: California CCLD inspection records | Data: last 90 days as of Feb 16, 2026

How to Avoid Required Enrollment Forms Citations

✓ Prevention Checklist

Provide all three required forms at time of enrollment
Use current versions of LIC 995A, LIC 995E, and LIC 9212 forms
Give forms to parent or authorized representative directly
Keep copies in child's file showing forms were provided
Update forms when new versions are released by licensing

❌ 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Using outdated form versions.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.

Los Angeles County

2 citations

Shasta County

1 citations

Solano County

1 citations

Monterey County

1 citations

San Diego County

1 citations

Data updated weekly from CCLD public records. Last update: 2/16/2026

See California Code § 102419(d): Required Enrollment Forms Citations in Your County

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Frequently Asked Questions

What is Required Enrollment Forms?

California Code 102419(d) requires you to provide every parent with three specific licensing forms at the time of enrollment: the Parent's Rights notice (LIC 995A), the Caregiver Background Check Process (LIC 995E), and the Consumer Awareness Information (LIC 9212). Each form serves a different purpose, from explaining background check procedures to outlining a parent's right to visit unannounced. Skipping even one of the three counts as a separate deficiency during an inspection.

How common is the Required Enrollment Forms citation?

According to California CCLD inspection records as of February 08, 2026, 10 facilities have been cited for this violation in the past 90 days across 7 California counties. That's roughly 1 in 4,000 inspected facilities, or about 0.02%. Los Angeles County accounts for 3 of those citations, with San Diego at 2. Santa Cruz, Shasta, and Solano each had one. This citation tends to come up during routine file reviews when inspectors pull random enrollment folders.

What triggers this citation during an inspection?

Inspectors open children's enrollment files at random and check for all three forms by name and version date. Based on CCLD inspection patterns, they flip to the footer of each form to confirm the revision date matches the current version (LIC 995A dated 8/06, LIC 995E dated 6/05, LIC 9212 dated 10/05). A missing form, an outdated version, or no parent signature acknowledging receipt all get documented as deficiencies. They also note whether forms were clearly added after enrollment, since recently printed pages in an old file stand out.

How can I prevent this citation?

Build an enrollment packet with all three forms pre-loaded, and include a signed acknowledgment sheet listing each form by name. Print fresh copies from the CDSS website every six months so you're always using current versions. Before filing any new enrollment, do a quick three-form check: 995A, 995E, 9212, plus the parent's signature. It takes 30 seconds and prevents a write-up that could have been avoided entirely.

What should I do if I receive this citation?

Get the correct, current-version forms to every affected family immediately. Have parents sign and date a new acknowledgment sheet, and file it alongside the original enrollment paperwork. Don't backdate anything. In your Plan of Correction, describe your updated enrollment checklist and how you'll verify form completeness going forward. Audit every active enrollment file within the week to catch other gaps before the follow-up visit. For complex situations, consider consulting a licensed childcare compliance specialist.

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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.

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