LIC 421CC - Civil Penalty Assessment Child Care

Form LIC 421CC is a civil penalty assessment form specific to child care facilities in California. The form is completed by the California Department of Social Services (CDSS) to notify the facility operator or licensee about assessed civil penalties for violations related to child care regulations. It includes information about the specific violation(s), the amount of the penalty, and payment instructions. By utilizing this form, the CDSS enforces compliance with child care standards and promotes the safety and welfare of children in licensed facilities.