4562.
A parent of a minor child may execute a power of attorney to provide for the care of the parent’s minor child only pursuant to this part. A power of attorney to care for the parent’s minor child shall comply with, and is subject to, this division and shall additionally include all of the following information:(a) Name and address of the parent executing the power of attorney.
(b) (1) Name and address of the parent who did not execute the power of attorney, if known.
(2) The information described in subdivision (b) of Section 4564.
(c) Name and address of the attorney-in-fact or agent who is authorized to provide care for the minor child.
(d) Name and birth date of the minor child.
(e) (1) Specification of the authorized powers of the attorney-in-fact or agent to provide care for the minor child.
(2) Special instructions limiting or extending the powers granted to the attorney-in-fact or agent.
(f) The effective date or conditions of effectiveness pursuant to either of the following:
(1) The date and the duration or period of time that the power of attorney takes effect.
(2) The occurrence of a specified event or contingency, including, but not limited to, the incapacity, absence, or detention of the principal, that causes the power of attorney to take effect.
(g) The date of the execution of the power of attorney.
(h) All of the following information in substantially the same form:
(1) TO SCHOOL OFFICIALS:
This power of attorney constitutes a sufficient basis for a determination that the attorney-in-fact or agent has certain powers to provide care for the minor child as specified by the executing parent in the power of attorney, unless the school district has actual knowledge of facts contrary to those stated in the power of attorney.
(2) TO HEALTH CARE PROVIDERS AND HEALTH CARE SERVICE PLANS:
A person who acts in good faith reliance upon a power of attorney for the care of a minor child allowing an attorney-in-fact or agent to consent to and direct medical, dental, or mental health care, without actual knowledge of facts contrary to those stated in the power of attorney, is not subject to criminal liability or to civil liability to any person, and is not subject to professional disciplinary action, for that reliance on the power of attorney.
(3) TO ALL OTHER THIRD PARTIES:
A person who acts in good faith reliance upon a power of attorney for the care of a minor child allowing an attorney-in-fact or agent to consent to and direct care of the minor child, handle finances for the minor child, or other related matters pertaining to the minor child, without actual knowledge of facts contrary to those stated in the power of attorney, is not subject to criminal liability or to civil liability to any person, and is not subject to professional disciplinary action, for that reliance on the power of attorney.