LARGE FAMILY DAY CARE APPLICATION (7 TO 12 CHILDREN) Street City State/Zip. Street City State/Zip. Site Address: Assessors Parcel No.

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CITY OF PERRIS DEVELOPMENT SERVICES DEPARTMENT PLANNING DIVISION 135 N. D Street Perris, CA 92570-2200 TEL.: (951) 943-5003 FAX: (951) 943-8379 FOR OFFICE USE ONLY DATE SUBMITTED LARGE FAMILY DAY CARE APPLICATION (7 TO 12 CHILDREN) AND NON-COMMERCIAL APPLICATION (13+ CHILDREN) RESIDENTIAL CARE FACILITIES RECEIVED BY PLANNING RECEIPT NO Applicant: Mailing Address: Owner: Mailing Address: Last First Telephone No. Street City State/Zip Last First Telephone No. Street City State/Zip Site Address: Assessors Parcel No.(s): Complete Project Description: Number of Children: Age Range of Children: Hours of Operation: Number of Outside Employees: State License Number: Applicant s Signature: Date: GROUP HOME LICENSING INFORMATION 951/782-4207 WWW.CCLD.CA.GOV CHILD CARE/DAY CARE LICENSING 951/782-4200 1

PROPERTY OWNER(S) AUTHORIZATION FORM AUTHORIZATION FOR AGENT TO ACT ON BEHALF OF LEGAL PROPERTY OWNER I/We, the owner(s) of the subject property, do hereby authorize to act in my/our behalf on matters pertaining to (Describe nature of request: i.e., Development Plan Review, Family Day Care, Conditional Use Permit, etc.) Dated this day of,20. Signature(s) of Legal Owner(s) State of California ) County of Riverside ) On this day of, 20, before me a Notary Public, personally appeared known to me to be the person(s) whose name(s) are/is subscribed to the within instrument and acknowledged that he/she/they executed the same. Witness my hand and Official Seal Signature Name (printed) 2

APPLICATION REQUIREMENTS Operation of a large family day care home shall be subjected to the review and approval of a large family day care permit by the Community Development Director in accordance with the following: A. Not less than ten (10) days prior to the decision date by the Community Development Director, the City shall mail notices of the proposed use to all property owners as shown on the last equalized assessment rolls within a one hundred (100) foot radius of the property boundaries of the proposed large family day care home site. B. A decision on the Permit shall be made by the Community Development Director, without a formal hearing, unless one is requested by either the applicant or other affected persons. For the purpose of this chapter, an affected a person shall mean a person who owns or who lives or works within a 100 foot radius of the proposed facility. If so requested, the hearing shall be scheduled for the next available Planning Commission hearing and the Planning Commission shall hear the request. Unless otherwise appealed, the decision of the Director of the Community Development Department shall be final. The application shall submit an application for a Large Family Day Care Home Permit pursuant to the submittal requirements on file with the Planning Division, which shall include, but not limited to, the following: Provide a statement that the applicant is the owner are the authorized agent of the owner of the property on which the Large Family Day Care Home Permit is proposed to be operated. A Statement that the Large Family Day Care operator is a resident at the home. Submit 5 sets of floor plans and site plans, fully dimensioned, indicating the type, use and location of all rooms, buildings, structure, parking and play areas. The Community Development Director may require additional information, material or plans, if necessary. The Director may also authorize omission on any plans and drawings required by this action if he/she deems it unnecessary. List of all assessor s parcel numbers and record owners of all properties, within a 100 foot radius, based upon the last equalized tax roll, and one copy of assessor s map and maps indicating all listed parcels (see page 5 for additional details). 3

Pursuant to the California Health and Safety code Section 5967.46, a permit for a Large Family Day Care Home is approved under the following: I. Agency clearances. Property state licensing shall be obtained prior to operation, including provisions for Fire Department clearance. II. Development Standards. In accordance with the purpose of this chapter, all large family day care homes shall comply with the development standards for the zoning district in which they are located, including but not limited to the following: A. A six (6) foot high fence and/or wall shall be erected around the side and rear property lines, behind the front yard setback. B. Adequate parking and driveway, as required by the zoning district in which the facility is located shall be provided and maintained. C. One (1) off-street parking space for each outside employee shall be provided. Said parking space(s) may be provided on the driveway. D. Outdoor play area shall be located in the rear yard or side yard of the property, and not permitted within the front yard setback. III. Findings for granting permit. A. Site complies with all zoning criteria and development standards for residential development. B. Use is incidental and subordinate of its use for residential purposes. C. Facility has outdoor activity space for each child who is not an infant of 75 square feet. The outdoor area must be either owned or leased by the applicant, and cannot be shared with other property owners. D. Facility is located more than 500 feet from any other large family day care home or child day care center, or the Director determines that over concentration of the facilities within the area will not result from the facility. E. Facility has adequate off-street parking for the primary residential use and each employee F. Access and drop-off facilities will not interfere with traffic and circulation of the neighborhood and can be facilitated in a safe and effective manner G. Design will minimize to the degree possible, excessive noise impact s to adjoining properties. IV. Conditions of approval. The applicant shall be required to: A. Comply with the applicable provisions of the Uniform Building Code, as adopted by the City of Perris. B. Comply with any standards promulgated by the State Fire Marshal and the Riverside County Fire Department relating to the subject of fire and life safety in large family day care home, and the applicable provisions of the Uniform Fire Code. C. Be licensed or deemed exempt from licensure by the State of California as a large family day care home. D. Operators(s) reside at the residence. Additional care giver, required under State of California Health and Safety Code, need not live in the home. E. No signs advertising the use of the property as a family day care shall be permitted. F. Comply with any conditions imposed by the Director of the Community Development, deemed necessary to satisfy the requirements III (findings). I hereby certify, that I am the operator of the Large Family Day Care Facility, and that I agree to adhere to al the conditions of approval, comply with the development standards, and meet the necessary findings to operate said facility. Failure to comply with these requirements will result in the forfeiture of the Large Family Day Care Permit. Applicant Date 4

REQUIRED PROPERTY OWNER(S) NOTIFICATION INFORMATION THE FOLLOWING ITEMS WILL BE REQUIRED. 1. TWO identical packages to be inserted in separate 8 ¾ x 11-¼ manila envelopes. These envelopes shall indicate the case number and the word labels, and shall contain the following: a. One typed set of gummed labels indicating all the property owner(s) name(s) and the mailing addresses that are within a 100-foot radius of the exterior of their proposed project (this list shall be ascertained from the last equalized assessment roll). b. One label for the owner/applicant/engineer. c. A photocopy of the aforementioned labels. 2. Two typed sets of gummed labels of the applicant, owner, engineer, and representative with their mailing addresses. Do not include duplicate sets where applicant and owner, etc. are the same. These should be inserted in a letter-sized envelope and stapled to the outside of one of the large manila envelopes mentioned in item 1 above. 3. Certification by a title company that the above list is complete and accurate. 4. On a copy of your exhibit or tentative map show all parcels within 100 feet (on the map), and print the names of all property owners within 100 feet as they are listed on the gummed labels. 5. A 100-foot radius map on assessor s map pages. PROPERTY OWNERS CERTIFICATION, certify that on the (Print name) (month-day-year) attached property owners list was prepared by (Print company or individual s name) pursuant to application requirements furnished by the City of Perris, Community Development Department, Planning Division. Said list is a complete and true compilation of owner of the subject property and all other owners within 100 feet of the property involved in the application and is based upon the latest equalized assessment rolls. I further certify that the information filed is true and correct to the best of my knowledge. I understand that incorrect or erroneous information may be grounds for rejection or denial of the application. NAME TITLE/REGISTRATION ADDRESS PHONE SIGNATURE DATE FAX _ 5