California Caregiver's Authorization Affidavit: who signs it and what it allows

What is a Caregiver's Authorization Affidavit?

It is a short sworn statement, in the form set out in Family Code §6552, by an adult who is caring for a child in their own home. Under Family Code §6550(a), a caregiver 18 or older, with whom the child lives, who completes items 1–4 and signs it may enroll the child in school and consent to school-related medical care. A caregiver who is a relative and completes items 1–8 gets the same rights to authorize medical and dental care that a guardian has under Probate Code §2353.

In a family preparedness plan for a parent's absence, it is the document the adult who takes the child in can use for school matters and, if that adult is a relative who completes items 5–8, for other medical care too.

Instructions: Completion of items 1–4 and the signing of the affidavit is sufficient to authorize enrollment of a minor in school and authorize school-related medical care. Completion of items 5–8 is additionally required to authorize any other medical care. Print clearly.

The minor named below lives in my home and I am 18 years of age or older.

Who signs the caregiver affidavit in California?

The caregiver signs it, not the parent. The courts' information sheet says the form "does not need a parent signature."

That is why it is not a power of attorney. A power of attorney is signed by a parent to hand over authority; this affidavit is the caregiver's own statement of facts they know. The form has one line for one child and one signer, so a caregiver looking after two children completes two affidavits.

This affidavit, a parent-signed medical consent, a nomination of guardian and a court guardianship are compared on temporary guardianship without court in California.

When can the caregiver sign it?

Only once the child actually lives in the caregiver's home. The first sworn sentence is "The minor named below lives in my home," so signing earlier means signing a false statement under penalty of perjury.

The statements become sworn only when the caregiver signs. A family preparing in advance can fill in the details now and leave the form unsigned; the caregiver reads every statement, then signs and dates it on or after the day the child moves in. A relative checks item 5 and, in item 6, only what is true that day.

Warning to Caregiver: Do not sign this form if any of the statements above are incorrect, or you will be committing a crime punishable by a fine, imprisonment, or both.

What can a relative and a non-relative caregiver do with it?

Any adult caregiver the child lives with can use it for school enrollment and school-related medical care. Only a relative who completes items 5–8, including item 6 (the parent was told of the plan to authorize medical care and did not object, or cannot be reached now), can also consent to other medical and dental care.

"School-related medical care" (§6550(h)(3)) means care such as immunizations and physical or medical exams that a state or local authority requires for school enrollment or for extracurricular activities related to the local educational agency, such as the school district.

Being a godparent, compadre or comadre, neighbor or family friend does not by itself make someone a relative: unless they are also related to the child by blood, adoption or marriage, only items 1–4 apply, even if the child calls them aunt or uncle. For care beyond school, Family Code §6910 is a separate route: a parent with legal custody signs a written authorization for the adult caring for the child to consent to medical and dental care (consent to treatment, not custody). See medical consent form for a minor. The form also warns non-relatives that the law may require resource family approval.

Who counts as a "relative" since January 1, 2026?

An adult related to the child by blood, adoption or affinity (marriage) within the fifth degree of kinship, including all stepparents and stepsiblings, every relative whose title starts with "great," "great-great" or "grand," and their spouses.

"Relative" means an adult who is related to the child by blood, adoption, or affinity within the fifth degree of kinship, including all stepparents, stepsiblings, and all relatives whose status is preceded by the words "great," "great-great," or "grand," or the spouse of any of the persons specified in this definition, even after the marriage has been terminated by death or dissolution.

Before 2026 it was a closed list: spouse, parent, stepparent, siblings (including step- and half-siblings), uncle, aunt, niece, nephew, first cousin, anyone with a "grand" or "great" title, and their spouses.

Is a caregiver the same as a guardian?

No. A guardian is appointed by a probate court and has legal custody; a caregiver who signs this affidavit does not, and the form states that it does not affect the parents' rights.

This declaration does not affect the rights of the minor's parents or legal guardian regarding the care, custody, and control of the minor, and does not mean that the caregiver has legal custody of the minor.

The information sheet says it cannot be used to keep a child against the parent's wishes. Legal custody comes only from a court: a caregiver can ask the probate court to appoint them guardian, and since 2026 Probate Code §2105(g) lets a court, in its discretion, appoint a temporarily unavailable custodial parent and the person that parent nominated as joint guardians, for circumstances the parent specified in the nomination and, if a noncustodial parent objects, only with a finding under Family Code §3041 that custody by that parent would be detrimental to the child; see nomination of guardian in California.

What changed in the 2026 caregiver affidavit form (AB 495)?

AB 495, the Family Preparedness Plan Act of 2025 (Statutes 2025, chapter 664), rewrote Family Code §6550 and §6552 effective January 1, 2026. Compared with the earlier text:

• Relative: the closed list became the fifth-degree-of-kinship definition above, and item 5 now reads "I am a relative of the child" instead of "I am a grandparent, aunt, uncle, or other qualified relative of the minor."
• Item 8: it now accepts a "government-issued consular card number" as well as a California driver's license or ID card number. The form does not list which consular cards qualify. As before 2026, a caregiver with none of these can give another ID, such as a Social Security or Medi-Cal number.
• New boxed warning to schools and health care providers (headed "Notice" on the courts' plain-language form): no court seal or signature is required, and no notary.
• School-related medical care now also covers care required for extracurricular activities related to the local educational agency, not only for enrollment.

Not changed: there was no expiration date before 2026 and there is none now. And there is no category for "nonrelative extended family members": committee analyses of an April 2025 draft described one, but the enacted law covers relatives only. Pre-2026 copies still circulate on school and clinic websites; a current one says "relative" in item 5, mentions a consular card in item 8 and, besides the warning to the caregiver, has a boxed statement to schools and health care providers that no court seal and no notary are needed. That matters because §6550(g) makes an affidavit invalid unless it substantially contains the §6552 warning statements in at least 10-point bold type inside a box. AB 495's other changes are in the family preparedness plan guide.

How long is a caregiver authorization affidavit valid?

It has no expiration date. Neither §6550 nor the §6552 form sets a time limit, and the information sheet with the courts' January 2026 form says: "The Caregiver's Authorization Affidavit does not expire." It ends when the child moves out: the caregiver must then notify every school, health care provider and health plan that received it, and under §6550(f) it is invalid once they receive that notice. The courts' self-help page also says parents "can cancel it at any time," and under §6550(b) a parent's contrary medical or dental decision controls unless it jeopardizes the child's life, health or safety. It applies only to a minor, so it has no use once the child turns 18.

3. If the minor stops living with you, the affidavit is no longer valid. You are required to notify any school, health care provider, or health care service plan to which you have given this affidavit that the minor is no longer living with you and that, as a result, the affidavit is no longer valid.

Does a caregiver affidavit need to be notarized?

No. The caregiver signs it under penalty of perjury and it is not filed with any court. Since 2026 the statutory form carries a boxed warning to schools and health care providers that ends: "This form is not required to be notarized."

Can a grandparent use a caregiver affidavit to enroll a child in school?

Yes, if the child lives with the grandparent. Any adult caregiver the child lives with can complete items 1–4 for school, and a grandparent is a relative under §6550(h)(2), so a grandparent who also completes items 5–8 can consent to other medical and dental care, as long as item 6 is true.

Under Education Code §48204(a)(5), the affidavit is a sufficient basis for finding that the child lives in the caregiver's home, unless the district determines from actual facts that the child does not live there. The district may ask for reasonable evidence of the address, such as a utility bill, and the school may still ask for its usual enrollment records, such as immunization records under Health and Safety Code §120335.

What if a school or provider won't accept it?

The law lets schools and providers rely on a completed affidavit without investigating (§6550(d)), and protects a provider who relies on it in good faith, without knowing of contrary facts, from liability and professional discipline for that reliance, if the applicable items are completed (§6550(c)).

The courts' self-help page notes that staff are sometimes unfamiliar with the form. A caregiver can point them to the notices on the back and bring proof of address. If an office still refuses, a court self-help center or a legal aid organization on LawHelpCA can help. Health insurance is separate: the courts note that most insurers will not add someone else's child without a court order, such as a guardianship.

How do you fill out the caregiver authorization affidavit, item by item?

Items 1–4 are for every caregiver; items 5–8 only for a relative who will also consent to other medical and dental care.

In the PDF RightForms prepares, items 1–4 come from the questionnaire. The boxes in items 5 and 6 are always printed unchecked: they are the caregiver's own sworn facts, marked at signing. Items 7 and 8 are printed only when the questionnaire says the caregiver is a relative and gives those details; otherwise they are blank lines. Each child and each caregiver gets a separate affidavit, with both warnings in bold inside boxes as §6550(g) requires, a "when to sign" instruction after the signature line, the statute's notices on the back and no notary block.

Where can you get the free official form, and what does RightForms add?

The official form is free on the courts' website: the fillable English PDF, revised January 1, 2026, with an information sheet, and the Spanish translation, labeled for information only. The courts' version is a plain-language edition; the statute requires the affidavit to be "in substantially the following form" set out in §6552.

RightForms prepares this affidavit from a questionnaire in English, Spanish or Russian and produces a PDF that follows the §6552 text. It does not file anything, give legal advice or decide which documents a family needs; see how RightForms works.

Do other states use the same caregiver affidavit?

No. The courts' information sheet says it is "valid only in California." Other states have their own forms; an expiration date or notary requirement in one of them is not California law.

What this page does not answer

This page does not cover an existing custody order, family court case or juvenile dependency case (the affidavit changes no court order); a parent who objects or parents who disagree; a child who will live outside California; special education decisions or health insurance enrollment; or the parent's own health care, money or property. For those, the courts' self-help centers and the legal aid directory at LawHelpCA are starting points.