The LIC 610A is the California Department of Social Services Emergency Disaster Plan form that every licensed family child care home must complete to document how the provider will handle fires, earthquakes, floods, and other emergencies. You download the current PDF from the CDSS forms directory, fill in all seven sections, pair it with a LIC 999A facility sketch, and submit both with your initial license application to the Community Care Licensing Division regional office that covers your county. Once your license is approved, the completed plan has to stay posted near a telephone in your home for as long as you operate.
Who the Form Is For
The LIC 610A is specifically for family child care homes, both small and large. If you run a child care center rather than a home-based program, you need the LIC 610 instead. That form has a different layout and covers additional center-specific protocols, and the two track different regulatory sections under Title 22 of the California Code of Regulations. Submitting the wrong one will delay your application.
Where to Get the Form
The LIC 610A is a free PDF on the CDSS website under the forms directory. The current revision is dated January 2022. You can also request a paper copy from your regional licensing office. The form carries built-in instructions, but they are brief, so the section-by-section notes below cover the places most applicants stumble.
Filling Out the LIC 610A Section by Section
The form has seven numbered sections. Complete every field. Blanks are treated as deficiencies during licensing review.
Section 1: Life-Threatening Emergencies
This section captures the identifying information a dispatcher needs. Enter the phone number you would call from, your home address exactly as it appears on your license application, the nearest major crossroad, and directions from that crossroad to your home. The crossroad and written directions matter more than they look. During a large-scale disaster, GPS can fail and responders may rely on the physical description you wrote here.
Section 2: Emergency Names and Telephone Numbers
List local numbers for fire and paramedics, police or sheriff, the hospital you would use, the Red Cross, poison control, your regional licensing office, ambulance services, Child Protective Services, the Office of Emergency Services, and any other relevant contact. These are local emergency service numbers, not your personal contacts or staff phones. Look up the non-emergency direct lines for each agency rather than listing 911 for every entry.
Section 3: Facility Evacuation
Section 3 ties directly to your LIC 999A sketch. On a copy of the floor plan, draw arrows showing the safest exit route from each room. The form reminds you to confirm that exit doors are not locked from the inside. If children use rooms on a second floor, trace the evacuation path carefully and make sure it does not route them through a hazard zone like the kitchen.
Section 4: Temporary Relocation Sites
You need two relocation sites with a name, phone number, and street address for each. The form does not dictate distance, but think practically. If one site is a neighbor across the street, the second should be far enough away that a localized event like a gas leak or downed power line would not affect both. Community centers, churches, and a family member’s home in a different neighborhood are common second choices. Contact each site in advance and confirm they will accept you and the children in an emergency.
Section 5: Utility Shut-Off
Record the location of your gas, electric, and water shut-offs and the phone number for each utility company. Walk the property and verify the locations before writing them down. Mark them on your LIC 999A sketch as well. The evaluator will check that the sketch and the LIC 610A are consistent.
Section 6: Equipment Location
Enter the location of your fire extinguisher and, if you have one, your fire alarm. The extinguisher has to be mounted or stored where an adult can reach it quickly but children cannot get at it unsupervised.
Section 7: Other Emergency Equipment
List each smoke detector’s location and type (ionization, photoelectric, or dual-sensor). If you have carbon monoxide detectors, battery-powered radios, or other supplies, note those too. The open field at the bottom is for additional equipment. A thorough entry gives the evaluator confidence that you have thought the plan through.
The LIC 999A Facility Sketch
The LIC 999A has to accompany the LIC 610A. It consists of two sketches: a floor plan of the interior and a layout of the yard and outdoor areas.
For the floor plan, label every room (kitchen, bathroom, living room, bedrooms) and show the dimensions. Mark all door and window exits, and identify any rooms that will be off-limits to children in care. The sketch should be roughly to scale. It does not have to be architecturally precise, but proportions should be close enough that someone unfamiliar with the home could navigate it.
For the yard sketch, show every structure on the property: the home itself, any garage or storage building, walkways, driveways, fences, gates, and the designated play area. Flag hazards like pools, animal enclosures, or garbage storage. Mark any off-limits areas.
Once both sketches are drawn, go back to Section 3 of the LIC 610A and add the evacuation arrows and utility shut-off locations onto a copy of the floor plan. The evaluator reviews the two documents side by side, and contradictions between them will trigger a revision request.
Submitting the Form
The LIC 610A goes in as part of your initial license application packet. The CDSS checklist for family child care homes (the LIC 279A instructions) lists the Emergency Disaster Plan alongside criminal record statements, TB clearances, the facility sketch, and proof of orientation completion.
Send the full packet to the Community Care Licensing Division regional office assigned to your geographic area. California has multiple child care regional offices, and a directory with addresses and phone numbers is posted as a PDF on the CDSS Community Care Licensing page. If you are not sure which office handles your county, call the main CDSS licensing line and they will direct you. Most applicants mail the packet, but some regional offices accept documents by email or through a digital portal. Call your office to confirm.
A licensing evaluator reviews the plan as part of the overall application. If the evaluator finds missing information or inconsistencies between your LIC 610A and the facility sketch, you will receive a written notice asking for corrections. Respond promptly. Unresolved deficiencies hold up the entire license.
Posting and Updating the Plan
Once your license is approved, post the completed LIC 610A in a conspicuous place near a telephone in your home. This is a regulatory requirement, not a suggestion, and evaluators check for it during inspections. Keep the evacuation routes from your facility sketch visible near exits so anyone in the home can find them during an emergency.
You are responsible for updating the LIC 610A whenever your circumstances change. If a relocation site closes, if you renovate and alter exit routes, or if emergency service phone numbers change, revise the form and send an updated copy to your regional licensing office. The form itself states that the “licensee is responsible for updating information as required.”
Running the Required Drills
Having the plan on paper is only half the requirement. California Code of Regulations Title 22, Section 102417(g)(9)(A) requires every family child care home to conduct fire drills and disaster drills at least once every six months. All children in care, as their age and ability allow, along with the provider, any assistant provider, and household members, must participate. Newly enrolled children should be informed of their responsibilities under the plan as soon as practical after enrollment.
Document each drill with the date and time and keep the log at your home. Licensing evaluators review drill logs during inspections, and a missing or outdated log is a common deficiency finding. The state does not mandate a format. A notebook or printed drill log works, as long as the record exists.
Penalties for Noncompliance
Operating without a completed emergency disaster plan, or failing to correct deficiencies identified during inspection, exposes you to civil penalties. For family child care homes, the penalty structure under Title 22 varies by violation type. Certain administrative deficiencies carry an immediate penalty of $100 per violation per day for up to five days, with repeat violations within twelve months escalating to $100 per day for up to thirty days. Noncompliance with a corrective plan can result in penalties of $50 per day until the deficiency is resolved.
Beyond fines, persistent noncompliance can lead to a formal deficiency citation on your licensing record, which parents and the public can view through the CDSS online facility search. In serious cases, the department may pursue revocation. The simplest way to avoid any of this is to treat the LIC 610A as a living document. Review it every few months, run your drills on schedule, and update the form whenever something changes.