
state of california–health and human services agency california department of social services community care licensing . child’s preadmission health history—parent’s report
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Live with an adult who has been incarcerated in the last five years. Live among, or are frequently exposed to, individuals who are homeless, migrant farm workers, users of street drugs, or …
The purpose of the Child’s Pre-Admission Health History – Parent’s Report (LIC 702) form is to gather information from the parent/guardian that will assist staff in identifying and assessing …
what time does child get up?* *wha t im edo sch ld g be ? p does child sleep during the day?* *when? h ow l ng? breakfast what are usual eating hours? breakfast lunch l dinner
Title: LIC 702 Author: CA Dept of Social Services Subject: Child's Preadmission Health History - Parent Report Created Date: 10/26/1999 10:25:33 AM
Licensing Form LIC 702 Child's Preadmission Health History …
Address: 1855 N. Orange-Olive Road, Orange, CA 92865 Phone: (714) 998-6650 Website: covp.org
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LIC702
do e s chi ld hav e f re q ue nt co lds ? y e s no ho w ma ny i n la s t y e a r? li s t a ny a lle rg i e s s ta f f s ho uld b e awa re o f
DAILY ROUTINES (*For infants and preschool-age children only) DEVELOPMENTAL HISTORY (*For infants and preschool-age children only) STATE OF CALIFORNIA–HEALTH AND …
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