Interested in enrolling your child? Complete the Application for Admission at your convenience. All the forms you will need are provided below.

Requirements to Enroll:

  • Current immunization record
  • TB clearance within the last 12 months
  • Physical within the last 12 months
  • Complete Admission packet and forms
  • At least 2 years of age
  • Potty Trained

Forms Download:

  • Application for Admission Form Download
  • Physical Form Form Download
  • Identification & Emergency Information Form Download
  • Child's Pre-Admission Health history (Parent Report) Form Download
  • Notification of Parent's Rights Form Download
  • Caregiver Background Check Process Form Download
  • Personal Rights Form Download

** All the forms must be completed per Department of Social Services, Community Care Licensing Division
The local licensing office, serving this center is:

Community Care Licensing
3737 Main Street Suite 700
Riverside, CA. 92501
(951) 782-4200

Licensed by the Department of Social Services,Community Care Licensing Division. License #334830856