Forms

ES = Spanish version available.

FormTitle
1099Operational Discipline and Guidance Policy 
1100Daily Buildings and Grounds Checklist 
2550Operational Policy on Infant Safe SleepES
2551Licensed and Registered Home: Caregivers, Assistants, Substitutes and Household Members Information Record 
2760Controlling Person – Child Care RegulationES
2819Residential Child Care Licensing Governing Body/Administrator or Executive Director Designation 
2820Educational Facility Request for Exemption from Child Care Regulation 
2832Single Skills Program During School Year Request for Exemption from Child Care Licensing Regulation 
2833Single Skills Program During Summer Request for Exemption from Child Care Licensing Regulation 
2837Governmental Entity Request for Exemption from Child Care Licensing Regulation 
2838Miscellaneous Entities Request from Child Care Licensing Regulation 
2839Program of Limited Duration Request for Exemption from Child Care Licensing Regulation 
2841Small Employer-Based Child Care or Temporary Shelter Child Care Facility Application 
2881Plan of Operation for School-Age Summer Program or Before/After School Program 
2885Children's Products Certification 
2906Child Placing Agency Internal Investigation Report 
2907CCL Statement of Foster Parent and Child-Placing Agency Rights and Responsibilities 
2910Application for a License or Certification to Operate a Child Day Care Facility 
2911Child Care Licensing Governing Body/Director Designation 
2912Pre-Employment Affidavit for Applicants for Employment at Certain Child Care OperationsES
2919Request for a Registration PermitES
2935Admission InformationES
2937Child Care Regulation Waiver/Variance Request 
2940Request for an Administrative ReviewES
2941Child Care Operation Sign-in/Sign-out Log 
2947Child Care Center Personnel Information Record 
2948Plan of Operation for Licensed Center and Home Operations 
2954Child Care Licensing Family Violence Calls DisclosureES
2960Application for a License to Operate a Residential Child Care Facility 
2961Request to Accept Children from Law Enforcement 
2962Verification of Liability Insurance 
2963Admission of a Child from a Law Enforcement Officer 
2971Child Care Licensing Request for Background CheckES
2974Request for Risk Evaluation Based on Past Criminal History or Central Registry Findings 
2982Personal History Statement 
2985Affidavit for Applicants for Employment with a Licensed Operation or Registered Child-Care Home ES
2986Listing Permit RequestES
2997Results of Public Hearing 
3004Family Foster Home Fire Safety Evaluation Checklist 
3014Administrator License - Renewal or Status Change 
3015Application for a Child Care Administrator License or a Child-Placing Agency Administrator License 
3016Administrator Licensing - Reference for an Applicant 
3017Child Care Regulation Request for Background Checks for an Administrator's License 
3018Administrator Licensing - Change in Contact Information 
3019Infant Sleep Exception/Health Care Professional RecommendationES
4001Renewal Application for Recognition of Day Care Administrator's Credential Program 
4003Foster Family Home Capacity Exception 
4004Residential Child Care Licensing Environmental Health Checklist 
7239Incident/Illness ReportES
7240Monthly Attendance Record 
7243Emergency Telephone Numbers 
7250Staff Training Record 
7255Medication AuthorizationES
7259Personnel Records Evaluation - Child Care Centers 
7260Children's Records Evaluation - Child Care Centers 
7261Center Records Evaluation 
7263Emergency Practices 
7270Children's Records Evaluation LCCH/RCCH 
7271Personnel Records Evaluation LCCH/RCCH 
7277Child Care Licensing Plan of Action