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CHILD CARE PROVIDER FORMS/MATERIALS



APPLICATION INFORMATION

  Center (The following pdf files need Adobe Reader to be opened. If you don't have Adobe Reader, please click here to download it.)
    Steps to Obtaining a Center Child Care License (pdf)
    Application (Northern) (Central) (Southern) (08/2008)
   
  Hourly Center (The following pdf files need Adobe Reader to be opened. If you don't have Adobe Reader, please click here to download it.)
    Steps to Obtaining an Hourly Center Child Care License (pdf)
    Application (Northern) (Central) (Southern)
   
  Family/Family Group (The following pdf files need Adobe Reader to be opened. If you don't have Adobe Reader, please click here to download it.)
    Steps for Obtaining a Family Child Care License (pdf)
    Application (Northern) (Central) (Southern) (08/2008)
    Basic Requirements for Licensed Family and RC Providers (comparison) (pdf)
   
  Residential Certificate (The following pdf files need Adobe Reader to be opened. If you don't have Adobe Reader, please click here to download it.)
    Steps to Obtaining a Child Care Residential Certificate (pdf)
    Application (Northern) (Central) (Southern)
    Basic Requirements for Licensed Family and RC Providers (comparison) (pdf)
     
BACKGROUND CHECKING INFORMATION
     
  Initial Form
    Initial Background Clearance Form -- CBS/MIS Consent and Release of Liability for Child Care (Northern) (Central) (Southern)
     
  Renewal Form
    Renewal Background Clearance for Family and Residential Certificate (Northern) (Central) (Southern)
    Renewal Background Clearance for Center and Hourly Center (Northern) (Central) (Southern)
     
  Disclosure Statement
    Background Clearance Disclosure Statement (pdf)
     
  BCI Instruction
    BCI Instructions (pdf) (08/2008)
     

TECHNICAL ASSISTANCE INFORMATION

  All Types of Providers (The following pdf files need Adobe Reader to be opened. If you don't have Adobe Reader, please click here to download it.)
    Approved Menus (pdf) (08/2008)
    Child Abuse Reporting Guide(pdf) (08/2008)
    Daily Sign In & Out Form (pdf) (08/2008)
    Do not Let Sleeping Babies Lie-in Car Seats(pdf) (08/2008)
    Handwashing Procedures Poster (pdf) (08/2008)
    Illness Information and Prevention Guidelines For Child Care Centers (pdf)
    Immunization Information (link)
    Medication Permission & Administration Form (pdf) (08/2008)
    Monthly Individual Child Sign In & Out (pdf) (08/2008)
    Number Required Training Hours for Newly Hired Staff (pdf) (08/2008)
    Poisonous Plants and Safe Plants (pdf) (01/2008)
    Posting Emergency Number (pdf) (08/2008)
    Provider Training Log (pdf) (08/2008)
   
  Center Providers(The following pdf files need Adobe Reader to be opened. If you don't have Adobe Reader, please click here to download it.)
    Admission Agreement and Health Assessment for Center (pdf) (08/2008)
    Diapering Procedure (pdf) (08/2008)
    Director Designee Authorization (pdf) (08/2008)
    Do not Let Sleeping Babies Lie-in Car Seats Center (pdf) (08/2008)
    Emergency & Disaster Plan Template (Word) (WordPerfect) (pdf)(08/2008)
    Fire & Disaster Drill Log (pdf) (08/2008)
    Infant Daily Record (pdf) (08/2008)
    Infant Daily Record 5 Days (pdf) (08/2008)
    Infant Daily Record 7 Days (pdf) (08/2008)
    Licensed Center Training Log with Topics(pdf) (08/2008)
    Minor Accident, Incident, or Injury Report (pdf) (08/2008)
    Orientation Training Log for Center (pdf) (08/2008)
    Policies and Procedures for Center (pdf) (08/2008)
    Provider Annual Training Log (pdf) (08/2008)
    Provider Training Log with Topics(pdf) (08/2008)
    Required Records (pdf) (08/2008)
    Serious Accident, Incident, or Injury Report (pdf) (08/2008)
    Summary of Cushioning Materials(pdf) (08/2008)
   
  In-home Providers (Licensed Family and Residential Certificate) (The following pdf files need Adobe Reader to be opened. If you don't have Adobe Reader, please click here to download it.)
    Admission Agreement and Health Assessment for Family (pdf) (08/2008)
    Emergency & Disaster Plan Template (Word) (WordPerfect) (pdf) (08/2008)
    Fire & Disaster Drill Log (pdf) (08/2008)
    Injury Prevention (pdf) (08/2008)
    Inspections for Safety Hazards (pdf) (09/2008)
    Minor Accident, Incident, or Injury Report (pdf) (08/2008)
    Orientation Training Log (pdf) (08/2008)
    Orientation Training Log for RC (pdf) (08/2008)
    Outdoor Environment (pdf) (08/2008)
    Parents Guide to Licensed Family (pdf) (08/2008)
    Parents Guide to RC (pdf) (08/2008)
    Policies and Procedures for Family (pdf) (08/2008)
    Required Records for Family (pdf) (08/2008)
    Serious Accident, Incident, or Injury Report (pdf) (08/2008)
    Supervision And Ratios (pdf) (08/2008)
    Training Log with Topics for Family (pdf) (08/2008)
    Training Log with Topics for RC (pdf) (08/2008)
    Trampoline Use Permission (pdf) (08/2008)
     
OTHER FORMS
     
  Appeal Form
    Appeal Form (Northern) (Central) (Southern)
     
  Variance Request Application
    Variance Request Application (Northern) (Central) (Southern) (3/13/08)
     
  GRAMA Request Form
    GRAMA (Information) Request Form (pdf)
     
  Licensor Evaluation
    Licensor/Inspection Evaluation (pdf)