How to Fill Out California Form LIC 279: Packet, Checks, and Submission

California Form LIC 279 is the one-page application you file with the Department of Social Services to open a licensed family child care home, and filling it out correctly means completing a mandatory orientation first, choosing between a small or large home license, entering each section exactly as instructed, and mailing it inside the larger LIC 279A packet with every supporting form and clearance attached. Miss any of those pieces and the packet comes back.

Complete the CCLD Orientation First

You cannot submit LIC 279 until you attend a Community Care Licensing Division orientation. CDSS will not process the application without proof you attended.¹ Register through the CDSS Child Care Licensing website for either an in-person session or the online version. The fee is $25 for family child care homes.²

If you take the online orientation, use a desktop or laptop that meets CDSS minimum operating system requirements. Phones and tablets are not supported. Save the completion certificate you receive at the end; it goes into your application packet as proof.

Decide Between a Small and Large Family Child Care Home

The form asks you to choose one license type, and that choice changes what else you have to submit. A small family child care home is licensed for up to six children, or up to eight if at least one child is six or older, another is enrolled in kindergarten or above, and no more than two children are infants.³ A large family child care home requires an assistant and is licensed for up to 12 children, or up to 14 under similar age-mix conditions, with no more than three infants at the expanded capacity.

Large homes also require a fire safety clearance and proof of child care experience; small homes do not.⁴ If you later want to expand from small to large, you file that capacity change through the same LIC 279.

Walking Through Each Section of the LIC 279

Always download a fresh copy of the form from the CDSS forms page. The current version was last revised in February 2023, and CDSS updates it periodically.⁵ The form is one page plus a signature block. Take it top to bottom:

Type of Application: Check whether this is a new application, a capacity change, a location change, or an update to an existing license.
Applicant Information: Your full legal name and confirmation that you are at least 18. If you have a co-applicant, both names go here.
Home Address: The street address where you will provide care, plus the county. If you have not lived in this county for the past two years, list the other counties where you resided.
Mailing Address: Fill this in only if it differs from your home address. Email is optional.
Directions to Home: Written driving directions so the licensing analyst can find your home for the inspection.
Prior Licensing History: Disclose whether you currently hold or have ever held a license or certification to care for children or adults, and include the license type, number, agency, and address if so.
Other Adults in the Home: First and last name of every adult who lives in the home, not counting you or a co-applicant. Do not list anyone under 18.
Current Children in Your Home: This section directs you to the LIC 279B, where you actually list them.
License Type and Operating Details: Select small or large home, the age range of children you plan to serve, and your intended days and hours.⁶
Perjury Statement: Sign and date under penalty of perjury that everything on the form is true and correct. Both applicants sign if there are two.

The single most common mistake is leaving the prior licensing history section blank instead of checking “No.” CDSS wants an affirmative answer either way, and blank fields get the application flagged as incomplete before anyone reads the substance.

The LIC 279A Packet: What Ships With the Form

LIC 279 is really a cover sheet. It goes inside the LIC 279A, the full application packet, which bundles the form with every required supporting document. Assemble all of this before mailing, because a partial submission comes back:⁷

LIC 279B, listing children who already live in your household (they count toward capacity).
LIC 508, the Criminal Record Statement, completed by each applicant.
LIC 610A, your written Emergency Care and Disaster Plan.
LIC 9108, your signed acknowledgment that you are a mandated reporter of suspected child abuse.
LIC 999A, the facility sketch. Draw a floor plan showing room dimensions, label each room, and circle the rooms children will use. Mark door and window exits. On the back, sketch the yard with fences, gates, play areas, driveways, and any hazards such as pools or animal pens.⁸
LIC 9217, the Pre-Licensing Readiness Guide self-assessment.
Your orientation completion certificate.
Proof of Preventive Health Practices training (completed or enrolled).
Current TB clearances (no more than one year old) for every adult in the home.
Child care experience documentation, for large home applicants only.
A check or money order for the application fee, payable to the Department of Social Services. The fee is nonrefundable and changes annually; confirm the current amount with your regional office or the CCLD fees page.²

Background Checks and Health Screening

Every adult who will live or work in the home has to clear a criminal background check before being present during child care operations. That includes you, any co-applicant, all adult household members, and any employees. Fingerprints go through Live Scan, and CDSS will not issue a license until clearances come back from both the California Department of Justice and the FBI.⁹ Anyone with a conviction beyond a minor traffic violation cannot be present in the facility unless the Care Provider Management Branch grants a criminal record exemption.¹⁰

A Child Abuse Central Index (CACI) check is also required for everyone associated with the home, and you cannot provide care until that clearance comes through. For a small home applicant, the government fees for Live Scan are $17 for the FBI check plus $15 for CACI, totaling $32 per person in mandatory state and federal fees. The Live Scan operator charges a separate rolling fee that varies by location, so total cost typically runs $50 to $80 per person.¹¹

Health screenings are separate. Each person working in the facility needs a health screening report (LIC 503) completed by or under the direction of a physician, done no more than one year before employment or within seven days after starting work. It covers general health, ability to perform assigned duties, a TB test, and immunization dates for pertussis, measles, and influenza.¹²

The Landlord Notification Checkbox

If you rent or lease your home, California law protects your right to operate a small family child care home at base capacity without the property owner’s permission. You do, however, have to notify the property owner in writing using the LIC 9151 (Property Owner/Landlord Notification) and keep a copy on file at home.¹³ The LIC 279 includes a checkbox where you confirm you have sent the notification.

Written consent from the property owner does become necessary if you plan to expand capacity, meaning six to eight children in a small home or 12 to 14 in a large home. That consent is documented on a separate form, the LIC 9149.⁶

Fire Safety Documentation

Small family child care homes do not need a fire clearance from the local fire department. You do have to demonstrate a working smoke detector and fire extinguisher that meet State Fire Marshal standards, and you provide the name, address, and phone number of the fire department or district with jurisdiction over your home.⁴

Large family child care homes need a fire safety clearance approved by your city or county fire department, district fire protection service, or the State Fire Marshal before the application is considered complete. The regulations define a completed application for a large home as one that includes the fire clearance along with all other documentation and a finished home visit.

Where to Send the Packet

Mail the full LIC 279A packet to the CCLD regional office that covers your area. CDSS runs an online Regional Office Search where you enter your address to find the correct office.¹⁴ Sending the packet to the wrong office delays everything, so confirm before you mail.

Include the check or money order for the application fee. The fee cannot be refunded once paid, even if the application is later denied, unless CDSS made a documented error.² CDSS does not currently accept credit cards for licensing fees.

What Happens After You Submit

A Licensing Program Analyst reviews the packet for completeness. If anything is missing or wrong, the analyst issues a notice of deficiency. You generally have up to 30 calendar days to fix it, though the analyst may extend that deadline if the correction genuinely cannot be finished in 30 days.¹⁵

Once paperwork clears, the analyst schedules an in-home inspection against a health and safety checklist covering water temperature, outlet covers, window openings, locked storage of medicines, cleaning supplies and firearms, stair gates, kitchen safety, and a working phone with a first aid kit, plus a yard walkthrough against your LIC 999A sketch.¹⁶ Passing the inspection and clearing background checks leads to license issuance. CDSS does not publish a fixed timeline; the total depends on how quickly clearances return, whether deficiencies need correcting, and the regional office’s workload.

Reasons Applications Get Denied

Knowing what trips other applicants up can save months:

A conviction beyond a minor traffic violation (under $300 fine) without a granted criminal record exemption produces automatic denial for initial applicants.¹⁷
A substantiated finding on the Child Abuse Central Index gives CDSS authority to deny.
If you or a household member needs a criminal record exemption but does not provide requested documents within 45 days, CDSS may deny the exemption, and with it the application.
Unpaid civil penalties from a prior period of unlicensed operation will block a new license until paid or covered by an acceptable payment arrangement.
When licensing requirements are not met, CDSS must deny the application within 30 days after receiving the completed submission.

A denial is not the end; you can reapply after resolving the underlying issue. Just do not continue operating in the meantime. CDSS can assess $200-per-day penalties for unlicensed operation, including operation that continues after a denial.

1
California Department of Social Services. Orientations For Community Care Facilities
2
California Department of Social Services. Community Care Licensing Licensing Fees
3
California Department of Social Services. License Application and Instructions for Family Child Care Homes
4
California Department of Social Services. Family Child Care Homes Regulations
5
California Department of Social Services. On-line Forms and Publications I – L
6
California Department of Social Services. Application for a Family Child Care Home License LIC 279
7
California Department of Social Services. License Application and Instructions for Family Child Care Homes
8
California Department of Social Services. Community Care Licensing Facility Sketch
9
California Department of Social Services. Background Check
10
California Department of Social Services. Background Check Process
11
California Department of Justice. Applicant Fingerprint Processing Fees
12
Foot Steps Child Care. Health Screening Report – Facility Personnel LIC 503
13
California Department of Social Services. Property Owner/Landlord Notification Family Child Care Home
14
California Department of Social Services. Child Care Licensing
15
California Department of Social Services. California Code of Regulations Title 22 Division 12 Chapter 1 – Section 101193 Deficiencies in Compliance
16
California Department of Social Services. Health and Safety Facility Checklist
17
California Department of Social Services. Family Day Care Home Regulations