The Lic 610A form is an essential document for family child care homes in California, serving as an Emergency Disaster Plan. This form outlines procedures and resources for handling emergencies, ensuring the safety of children and staff during critical situations. To effectively prepare for unforeseen events, it’s crucial to fill out this form accurately and keep it updated; you can start by clicking the button below.
In the realm of family child care homes, safety is paramount, and the Lic 610A form serves as a critical tool in ensuring preparedness for emergencies. This Emergency Disaster Plan outlines essential steps and resources to be utilized in life-threatening situations. It requires caregivers to provide vital information, such as emergency contact numbers, facility evacuation procedures, and temporary relocation sites. The form emphasizes the importance of having a clear evacuation route, which must be illustrated on a facility sketch, ensuring that everyone knows how to exit safely in case of a fire or other emergencies. Furthermore, it mandates the identification of utility shut-off locations and the placement of emergency equipment, such as fire extinguishers and first aid kits. Not only must this form be posted near a telephone for easy access, but it also needs to be kept up-to-date and submitted to the licensing office. By filling out the Lic 610A form accurately and thoroughly, family child care providers can create a robust plan that prioritizes the safety and well-being of the children in their care.
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING
EMERGENCY DISASTER PLAN FOR FAMILY CHILD CARE HOMES
Type or print clearly. Post next to phone. Keep current - Return a copy to the licensing office.
LICENSEE NAME:
DATE:
1.
EMERGENCIES - LIFE THREATENING - Call 9-1-1 - Tell them: Number Calling from:
HOME ADDRESS:
MAJOR CROSSROAD:
HOME DIRECTION FROM CROSSROAD:
2.
EMERGENCY NAMES AND TELEPHONE NUMBERS (In addition to 9-1-1)
Fire/Paramedics:
Office of Emergency Services:
Red Cross:
Licensing:
Ambulance:
Other:
Hospital:
Police/Sheriff:
Child Protective Services:
Poison Control:
3.FACILITY EVACUATION - Some disasters require evacuation of the building. Using a copy of the Facility Sketch (LIC 999A), show arrows for the safest way to exit rooms. Be sure that exit doors are not locked from the inside. In the event of a fire, get everyone out, follow the escape routes, meet at a prearranged location, account for everyone, do not let anyone return to the building and call the fire department.
4.TEMPORARY RELOCATION SITE(S) - Some disasters require moving to a safe location. When relocating, determine whether you need food, water, blankets and flashlight and meet at a prearranged easily accessible location. Be sure to obtain permission from the property owner.
NAME:
PHONE:
ADDRESS:
5.
UTILITY SHUT OFF -Indicate locations on the Facility Sketch (LIC 999A) with the exit routes.
GAS:
GAS CO. PHONE:
ELECTRIC:
ELECTRIC CO. PHONE:
WATER:
WATER CO. PHONE:
6.
EQUIPMENT LOCATION - The fire department may help you with installation information.
FIRE EXTINGUISHER LOCATION:
SMOKE DETECTOR LOCATION:
FIRE ALARM LOCATION ( IF YOU HAVE ONE):
TYPE
7.
OTHER EMERGENCY EQUIPMENT - Where appropriate identify location of first aid kit, blankets, food and water, flashlight, radio
and other emergency equipment.
LOCATION:
LIC 610A (6/05) PUBLIC
Need help filling out the Emergency Disaster Plan Form?
Applicants need to submit a plan to handle possible emergencies. The Emergency Disaster Plan is a plan that identifies resources when an emergency occurs. A copy of the form must be posted in a conspicuous place near a telephone and a copy given to the licensing agency with the application packet. Licensee is responsible for updating information as required and all information should be typed or clearly handwritten.
1.EMERGENCIES - LIFE THREATENING - Whenever a life threatening emergency occurs, use the 9-1-1 telephone number. Operators are able to speed dial help for any life threatening emergency. If the call is interrupted, they are usually able to identify the home address from the open line. It is important to write out exactly what needs to be said to direct help to the home. This means that you need to write out the home phone, the address of the home, the nearest major cross street and directions to the home from the cross street.
2.EMERGENCY NAMES AND TELEPHONE NUMBERS (In addition to 9-1-1) - This is a list of additional emergency resources that you may need. Most of the numbers are listed on the form. The Office of Emergency Services (OES) assists local government and the public with emergencies that threaten lives, property and the environment. The telephone number for your local OES can be found in the white pages of the telephone book under Government Listings, County Government Offices, “Emergency Operations”. It may also be found under County Sheriff’s Department. The “Other” is extra space for other numbers that you think may be needed in an emergency.
3.FACILITY EVACUATION - The most important action in a fire emergency is getting the children safely out and grouped together in a safe location. As part of your application packet, you need to complete a facility sketch. Take a copy of the sketch and identify the quickest exiting routes from each room. Copies of the exiting routes should be posted in conspicuous locations. You also need to identify a safe location where everyone should gather to be sure everyone is counted and no one remains in the building. You need to have regular fire drills with the children. Your fire department is an excellent resource for fire and evacuation instructions.
4.TEMPORARY RELOCATION SITES - In the event of an emergency or disaster, you need to make arrangements to move to a temporary site, such as at the home of a friend or a local church. You need to identify a second site in the event the first site is not immediately available in the emergency. Be sure to get permission from the property owner of the relocation site.
5.UTILITY SHUT OFF - In emergencies such as floods and earthquakes, it may be necessary to shut the utilities off. It is important to identify the locations of the utility shut off for such emergencies. You should also have a wrench on hand for the gas line. It also may be helpful to put the utility shut off locations on the Facility Sketch.
6.EQUIPMENT LOCATION - Your home must contain a fire extinguisher and smoke detector device which meet the standards established by the State Fire Marshal. The fire extinguisher must be in a location that is easily accessible and identified in this plan. The local fire department may help you with the location of fire equipment. In addition to smoke alarms, you need to identify and locate any other emergency alarms that are on the premises. If a fire is just beginning, it may be possible to extinguish the fire with a fire extinguisher. However, the children should be safely relocated before attempting to extinguish any fire.
7.OTHER EMERGENCY EQUIPMENT - In the event of a flood or earthquake, it may be necessary to have a first aid kit, blankets, food and water, radio, flashlight and other provisions. The plan needs to identify where this other emergency equipment is kept.
LIC 610A (6/05)
Filling out the Lic 610A form is essential for creating a solid emergency disaster plan for family child care homes. This plan helps ensure safety and preparedness in case of an emergency. After completing the form, it should be posted near a phone and a copy sent to the licensing agency.
What is the purpose of the Lic 610A form?
The Lic 610A form is an Emergency Disaster Plan specifically designed for Family Child Care Homes in California. It outlines procedures and resources to be utilized during emergencies, ensuring the safety of children and staff.
Who is responsible for completing the Lic 610A form?
The licensee of the Family Child Care Home is responsible for completing the Lic 610A form. They must ensure that the information is accurate and up-to-date.
Where should the Lic 610A form be posted?
The completed Lic 610A form should be posted in a conspicuous location near a telephone. This allows for quick access during emergencies.
What information is required on the Lic 610A form?
The form requires details such as:
How often should the Lic 610A form be updated?
The licensee should update the Lic 610A form as needed, especially when there are changes in contact information, emergency resources, or facility layout.
What should be included in the emergency contact numbers section?
This section should include local emergency services, such as:
What is the importance of a facility evacuation plan?
A facility evacuation plan is crucial for ensuring the safety of children during emergencies. It provides clear routes for exiting the building and a designated meeting place to account for everyone.
What should be done in case of a utility emergency?
In emergencies like floods or earthquakes, it may be necessary to shut off utilities. The Lic 610A form should indicate where the shut-off valves are located, and a wrench should be available for the gas line.
What types of emergency equipment should be included in the plan?
The plan should identify locations for essential emergency equipment, such as:
How can the local fire department assist with the Lic 610A form?
The local fire department can provide guidance on fire safety and evacuation procedures. They can also assist in identifying appropriate locations for fire extinguishers and smoke detectors.
Filling out the Lic 610A form can be straightforward, but many people make common mistakes that can lead to confusion or delays. One frequent error is failing to provide clear and legible information. Whether you are typing or writing by hand, clarity is essential. Illegible handwriting can result in miscommunication during emergencies, which could have serious consequences.
Another common mistake is neglecting to update the form regularly. The Lic 610A requires current information, especially regarding emergency contacts and relocation sites. Keeping this information up to date ensures that in an emergency, everyone knows who to call and where to go. Failing to do so can lead to unnecessary panic and confusion.
Many individuals also overlook the importance of including all necessary emergency contacts. While the form provides space for several numbers, some people leave out critical resources. For instance, not listing local hospitals or poison control can hinder prompt assistance during an emergency. Always take the time to include every relevant contact.
In addition, some people forget to indicate the locations of utility shut-offs on the Facility Sketch. Knowing where to shut off gas, water, and electricity can prevent further hazards during a disaster. This information should be clearly marked to ensure quick access in an emergency.
Another mistake involves the evacuation plan. Some individuals do not clearly outline the safest exit routes on the Facility Sketch. It is crucial to show arrows indicating the quickest way out of each room. This detail can save precious time and ensure the safety of everyone in the facility.
Additionally, neglecting to conduct regular fire drills is a frequent oversight. Practicing evacuation procedures with children helps them understand what to do in an emergency. Without these drills, children may panic and not follow instructions when it matters most.
People often forget to seek permission for temporary relocation sites. It's essential to have a backup plan for emergencies, but you must ensure that you have the property owner's consent. Failing to do so could lead to complications when trying to relocate.
Lastly, some individuals do not adequately identify the location of emergency equipment, such as fire extinguishers and first aid kits. This information should be easily accessible and clearly noted on the form. In an emergency, knowing where to find these items can make all the difference.
The Lic 610A form is an essential document for family child care homes in California, outlining an emergency disaster plan. However, several other forms and documents complement this plan, ensuring that child care providers are fully prepared for emergencies. Below are five important documents that are often used alongside the Lic 610A form.
By maintaining these documents alongside the Lic 610A form, family child care providers can create a comprehensive emergency preparedness plan. This proactive approach not only protects the children in their care but also fosters a sense of security among parents and staff.
The Lic 610A form, which outlines an Emergency Disaster Plan for Family Child Care Homes, shares similarities with several other important documents. Each of these documents serves to ensure safety and preparedness in various emergency situations. Below is a list of forms that are comparable to the Lic 610A, along with a brief explanation of their similarities:
Each of these documents plays a crucial role in ensuring that child care facilities are prepared for emergencies, just as the Lic 610A form does. Familiarity with these forms can enhance safety and compliance in child care settings.
When filling out the Lic 610A form, it’s important to be thorough and accurate. Here’s a list of things to do and avoid:
Misconceptions about the Lic 610A form can lead to confusion for family child care providers. Here are five common misunderstandings:
Understanding these misconceptions can help family child care providers better prepare for emergencies and ensure the safety of the children in their care.
Here are key takeaways for filling out and using the Lic 610A form: