Forms

ES = Spanish version available.

Form Title
1099 Operational Discipline and Guidance Policy  
1100 Daily Buildings and Grounds Checklist  
2550 Operational Policy on Infant Safe Sleep ES
2551 Licensed and Registered Home: Caregivers, Assistants, Substitutes and Household Members Information Record  
2760 Controlling Person - Child Care Licensing ES
2819 Residential Child Care Licensing Governing Body/Administrator or Executive Director Designation  
2820 Educational Facility Request for Exemption from Child Care Licensing Regulation  
2832 Single Skills Program During School Year Request for Exemption from Child Care Licensing Regulation  
2833 Single Skills Program During Summer Request for Exemption from Child Care Licensing Regulation  
2837 Governmental Entity Request for Exemption from Child Care Licensing Regulation  
2838 Miscellaneous Entities Request from Child Care Licensing Regulation  
2839 Program of Limited Duration Request for Exemption from Child Care Licensing Regulation  
2841 Small Employer-Based Child Care or Temporary Shelter Child Care Facility Application  
2881 Plan of Operation for School-Age Summer Program or Before/After School Program  
2885 Children's Products Certification  
2906 Child Placing Agency Internal Investigation Report  
2907 CCL Statement of Foster Parent and Child-Placing Agency Rights and Responsibilities  
2910 Application for a License to Operate a Child Day Care Facility  
2911 Child Care Licensing Governing Body/Director Designation  
2919 Request for a Registration Permit ES
2935 Admission Information ES
2937 Child Care Licensing Waiver/Variance Request  
2940 Request for an Administrative Review ES
2941 Child Care Operation Sign-in/Sign-out Log  
2947 Child Care Center Personnel Information Record  
2948 Plan of Operation for Licensed Center Operations  
2954 Child Care Licensing Family Violence Calls Disclosure ES
2960 Application for a License to Operate a Residential Child Care Facility  
2961 Request to Accept Children from Law Enforcement  
2962 Verification of Liability Insurance  
2963 Admission of a Child from a Law Enforcement Officer  
2971 Child Care Licensing Request for Background Check ES
2982 Personal History Statement  
2985 Affidavit for Applicants for Employment with a Licensed Operation or Registered Child-Care Home ES
2986 Listing Permit Request ES
2997 Results of Public Hearing  
3004 Family Foster Home Fire Safety Evaluation Checklist  
3008 Listed Family Home Fee Schedule ES
3009 Registered Child Care Home Fee Schedule ES
3010 Licensed Child Care Fee Schedule  
3011 Residential Child Care License Fee Schedule  
3012 Small Employer-Based Child Care Facility Temporary Shelter Child Care Facility Fee Schedule  
3014 Administrator License - Renewal or Status Change  
3015 Application for a Child-Care Administrator License or a Child-Placing Agency Administrator License  
3016 Administrator Licensing - Reference for an Applicant  
3017 Request for the Criminal History and Central Registry Checks Required for an Administrator's License  
3018 Administrator Licensing - Change in Contact Information  
3019 Infant Sleep Exception/Health Care Professional Recommendation ES
4001 Renewal Application for Recognition of Day Care Adminstrator's Credential Program  
4003 Foster Family Home Capacity Exception  
4004 Residential Child Care Licensing Environmental Health Checklist  
7239 Incident/Illness Report ES
7240 Monthly Attendance Record  
7243 Emergency Telephone Numbers  
7250 Staff Training Record  
7255 Medication Authorization ES
7259 Personnel Records Evaluation - Child Care Centers  
7260 Children's Records Evaluation - Child Care Centers  
7261 Center Records Evaluation  
7263 Emergency Practices  
7270 Children's Records Evaluation LCCH/RCCH  
7271 Personnel Records Evaluation LCCH/RCCH  
7277 Child Care Licensing Plan of Action