Child Care Home Provider Application Forms

Licensed Child Care Home Application

• Form 2910, Application for a License or Certification to Operate a Child Day Care Facility
• Form 2948, Plan of Operation for Licensed Center and Home Operations
• Form 2911, Child Care Licensing Governing Body/Director Designation
• Form 2760, Controlling Person – Child Care Regulation
• Form 2985, Affidavit for Applicants for Employment with a Licensed Operation or Registered Child-Care Home
• Form 2971, Child Care Regulation Request for Background Check
• Form 2974, Request for Risk Evaluation Based on Past Criminal History or Central Registry Findings

Registered Child Care Home Application

• Form 2912, Pre-Employment Affidavit for Applicants for Employment at Certain Child Care Operations
• Form 2919, Request for a Registration Permit
• Form 2760, Controlling Person – Child Care Regulation
• Form 2985, Affidavit for Applicants for Employment with a Licensed Operation or Registered Child-Care Home
• Form 2971, Child Care Regulation Request for Background Check
• Form 2974, Request for Risk Evaluation Based on Past Criminal History or Central Registry Findings

Listed Family Home Application

• Form 2986, Listing Permit Request
• Form 2760, Controlling Person – Child Care Regulation
• Form 2971, Child Care Regulation Request for Background Check
• Form 2974, Request for Risk Evaluation Based on Past Criminal History or Central Registry Findings