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CA CDPH 709 2008-2025 free printable template

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Facility name Facility address number street City State ZIP code California Building Floor Room Activity Room Size Floor Area Approved Capacity Nonambulatory Ambulatory Individual s Room Common Rooms Dining Recreation Living Library Storage CDPH 709 10/08 Page 1 of 2 over Additional Rooms This space may also be used for individual rooms where necessary. State of California - Health and Human Services Agency California Department of Public Health CLIENT ACCOMMODATIONS ANALYSIS This form is...
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How to fill out CA CDPH 709

01
Obtain the CA CDPH 709 form from the California Department of Public Health website or local health department.
02
Enter the child’s full name at the top of the form.
03
Provide the child's birth date and address in the designated fields.
04
Fill in the parent's or guardian's information, including name, address, and contact number.
05
Indicate the child's vaccination history by checking the appropriate boxes and providing dates for each vaccination.
06
If applicable, include any medical exemptions or special considerations related to the child's health.
07
Review the completed form for accuracy and completeness.
08
Sign and date the form where indicated.
09
Submit the form to the appropriate school or daycare center as required.

Who needs CA CDPH 709?

01
Parents or guardians of children entering school or daycare in California.
02
Students who are required to provide proof of immunizations.
03
Healthcare providers assisting families with vaccination documentation.

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CA CDPH 709 is a form used in California for reporting child abuse and neglect cases.
Mandated reporters, such as teachers, doctors, and social workers, are required to file CA CDPH 709.
To fill out CA CDPH 709, provide detailed information about the alleged abuse or neglect, including the child's information, details of the incident, and your contact information.
The purpose of CA CDPH 709 is to report suspected child abuse or neglect to the appropriate authorities for investigation and intervention.
Information that must be reported includes the child's name and age, details about the suspected abuse or neglect, names of the parents or guardians, and any relevant observations made by the reporter.
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