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STATEMENT ACKNOWLEDGING REQUIREMENT TO REPORT …

STATEMENT ACKNOWLEDGING REQUIREMENT TO REPORT …

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lic 9108 (3/05) page 1 of 2 position facility number state of california—health and human services agency california department of socialservices . statement acknowledging requirement to report child abuse note: retain in employee/licensee file . name .

  Department, California, Testament, Acknowledging, 1980, Socialservices, Statement acknowledging, California department of socialservices

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