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CHILD CARE PROVIDER FORMS/MATERIALS


APPLICATION INFORMATION
Center | Hourly Center | Family | Residential Certificate | Background Clearance | General

TECHNICAL ASSISTANCE MATERIALS
Center | Hourly Center | Family | Residential Certificate | Background Clearance | General

  Center (The following pdf files need Adobe Reader to be opened. If you don't have Adobe Reader, please click here to download it.)
    Annual Training Log without Topics (pdf) (5/2007)
    Annual Training Log with Topics (pdf) (5/2007)
    Orientation Training Log (pdf)
    Child Admission Agreement & Health Assessment (pdf)
    Diapering Procedure (pdf) (Last update: 01/2008)
    Diapering, Feeding, & Sleeping Record -- 5 day (pdf)
    Diapering, Feeding, & Sleeping Record -- 7 day (pdf)
    Medication Permission & Administration Form (pdf)
    Sign In & Out Form -- Daily (pdf)
    Sign In & Out -- Monthly Individual Child (pdf)
    Minor Accident, Incident, or Injury Report (pdf) (Last update: 11/2007)
    Serious Accident, Incident, or Injury Report (pdf) (Last update: 11/2007)
    Policies & Procedures Template (word) (wordperfect) (pdf)
    Fire & Disaster Drill Log (pdf)
    Emergency & Disaster Plan Template (word) (wordperfect) (pdf)
    Required Records Checklist (pdf)
    Handwashing Procedures Poster (pdf)
    Summary of Cushioning Materials (pdf)
    Illness Information and Prevention Guidelines For Child Care Centers (pdf)
    Approved Menus (pdf)
    Number Required Training Hours for Newly Hired Staff (pdf)
    Parent's Guide to Licensed Child Care Centers (pdf) (Last Update: 10/2007)
    Poisonous Plants and Safe Plants (pdf) (Last Update: 01/2008)
   
  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.)
    Annual Training Log with Topics(pdf)
    Annual Training Log without Topics (pdf)
    Orientation Training Log (pdf)
    Child Admission Agreement & Health Assessment (pdf)
    Diapering Procedure (pdf) (Last update: 01/2008)
    Medication Permission & Administration Form (pdf)
    Sign In & Out Form -- Daily (pdf)
    Sign In & Out -- Monthly Individual Child (pdf)
    Minor Accident, Incident, or Injury Report (pdf) (Last update: 11/2007)
    Serious Accident, Incident, or Injury Report (pdf) (Last update: 11/2007)
    Required Records Checklist (pdf)
    Required Records Checklist -- Children's Documentation (pdf)
    Fire & Disaster Drill Log (pdf)
    Emergency & Disaster Plan Template (word) (wordperfect) (pdf)
    Ratios Chart (pdf)
    Poisonous Plants and Safe Plants (pdf) (Last Update: 01/2008)
   
  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.)
    Annual Training Log with Topics (pdf)
    Annual Training Log without Topics (pdf)
    Orientation Training Log (pdf)
    Caregiver Health Evaluation (pdf)
    Child Admission Agreement & Health Assessment (pdf)
    Diapering Procedure (pdf) (Last update: 01/2008)
    Medication Permission & Administration Form (pdf)
    Sign In & Out Form -- Daily (pdf)
    Sign In & Out -- Monthly Individual Child (pdf)
    Minor Accident, Incident, or Injury Report (pdf) (Last update: 11/2007)
    Serious Accident, Incident, or Injury Report (pdf) (Last update: 11/2007)
    Required Records Checklist -- Children (pdf)
    Tobacco, Alcohol, Drugs, & Sexually Explicit Materials Policy (pdf)
    Emergency & Disaster Plan Template (pdf)
    Emergency & Disaster Plan Template -- New Center (word) (wordperfect) (pdf)
    Fire & Disaster Drill Log (pdf)
    Basic Requirements for Licensed Family and RC Providers (comparison) (pdf)
    Approved Menus (pdf)
    Number Required Training Hours for Newly Hired Staff (pdf)
    Poisonous Plants and Safe Plants (pdf) (Last Update: 01/2008)
   
  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.)
    Annual Training Log with Topics (pdf)
    Annual Training Log without Topics (pdf)
    Child Admission Agreement (pdf)
    Medication Permission & Administration Form (pdf)
    Minor Accident, Incident, or Injury Report (pdf) (Last update: 11/2007)
    Serious Accident, Incident, or Injury Report (pdf) (Last update: 11/2007)
    Basic Requirements for Residential Certificate and Family Providers (comparison) (pdf)
    Poisonous Plants and Safe Plants (pdf) (Last Update: 01/2008)
   
  Background Clearance (The following pdf files need Adobe Reader to be opened. If you don't have Adobe Reader, please click here to download it.)
    Initial Background Clearance Form -- CBS/MIS Consent and Release of Liability for Child Care (Northern) (Central) (Southern)
    Background Clearance Renewal Process (pdf)
    Renewal Background Clearance for Family and Residential Certificate (Northern) (Central) (Southern)
    Renewal Background Clearance for Center and Hourly Center (Northern) (Central) (Southern)
    Background Clearance Disclosure Statement (pdf)
     
  General (The following pdf files need Adobe Reader to be opened. If you don't have Adobe Reader, please click here to download it.)
    Caregiver Health Evaluation (pdf)
    Appeal Form (Northern) (Central) (Southern)
    Variance Request Application (Northern) (Central) (Southern) (3/13/08)
    Children in Care Chart (pdf)
    GRAMA (Information) Request Form (pdf)
    Licensor/Inspection Evaluation (pdf)
    13 Indicators of Quality Child Care
    Illness Information and Prevention Guidelines For Child Care Centers (pdf)
    Immunization Information (link)
     


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)
   
  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)
    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 Clearance (The following pdf files need Adobe Reader to be opened. If you don't have Adobe Reader, please click here to download it.)
    Initial Background Clearance Form -- CBS/MIS Consent and Release of Liability for Child Care (Northern) (Central) (Southern)
    Background Clearance Renewal Process (pdf)
    Renewal Background Clearance for Family and Residential Certificate (Northern) (Central) (Southern)
    Renewal Background Clearance for Center and Hourly Center (Northern) (Central) (Southern)
    Background Clearance Disclosure Statement (pdf)
     
    General
    Variance Request Application (Northern) (Central) (Southern)