Forms

ES = Spanish version available.

FormTitle
1099Operational Discipline and Guidance Policy
1100Daily Buildings and Grounds Checklist
2550Operational Policy on Infant Safe Sleep ES
2551Licensed and Registered Home: Caregivers, Assistants, Substitutes and Household Members Information Record
2760Controlling Person – Child Care Regulation ES
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 Operations ES
2919Request for a Registration Permit ES
2935Admission Information ES
2937Child Care Regulation Waiver/Variance Request
2940Request for an Administrative Review ES
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 Disclosure ES
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 Check ES
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 Request ES
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 Recommendation ES
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 Report ES
7240Monthly Attendance Record
7243Emergency Telephone Numbers
7250Staff Training Record
7255Medication Authorization ES
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