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Child Care Licensing Forms
Child Care Licensing Bureau forms are available on the website as Word Documents. The Word documents are fillable and are intended for electronic completion.
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Child Care Homes
Medication Permission Form - CCL-1243
Permiso e Instrucciones Para la Medicación Para Casas de Cuidado/Guarderias - CCL-1243-SPFamily and Group Home Increased Capacity and Ratio Request
Waiver for Decreasing Capacity
Request of Child Care Forms – CCL-2021
Child Care Licensing Information Request - CCL 001
Child Information Record - CCL-3731
Child Information Record - CCL-3731- ArabicBackground Check and Fingerprinting Information
Report of Actual or Suspected Child Abuse or Neglect - DHS-3200
Complete this form within 72 hours of calling in a suspicion of abuse or neglect.Notification of Changes in Status-Family and Group Child Care Home - CCL-1485
Medical Clearance Request - CCL-3704
Zoning Approval for Group Child Care Homes - CCL-3748
Child in Care Statement/Receipt - CCL-3900
Declaración/Recibo de Niños en Cuidado - CCL-3900-SPCorrective Action Plan - CCL-1894
Training Record Family/Group Child Care Homes - CCL-4590
Child Care Staff Member Certifications and Child Care Assistant Certifications - CCL-4595
Driver Verification - CCL-5039
Home Fire and Tornado Drill Record - CCL - 4593
Licensing Notebook Summary Sheet - CCL-5052
Request for Modification of the Terms of the License - CCL-5054
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Child Care Centers
Medication Permission Form - CCL-1243
Permiso e Instrucciones Para la Medicación Para Casas de Cuidado/Guarderias - CCL-1243-SPRequest of Child Care Forms – CCL-2021
Child Care Licensing Information Request - BCHS-CCL 001
Child Information Record - CCL-3731
Child Information Record - CCL-3731- ArabicBackground Check and Fingerprinting Information
Report of Actual or Suspected Child Abuse or Neglect - DHS-3200
Complete this form within 72 hours of calling in a suspicion of abuse or neglect.Child Care Center Notice of Arraignment or Conviction - CCL-1486
Written Information Packet Documentation CCL-4340
Change of Use Space Request for School-Age Programs Located in Schools CCL-4342
Lead Inspection Risk Assessment Summary CCL-4344
Lead Inspection Risk Assessment Waiver
Corrective Action Plan - CCL-1894
No Change in Building Construction Declaration CCL-2129
Infant/Toddler Primary Caregiver Documentation CCL-4557
Center Fire and Tornado Drill Record - CCL-4593
Staffing Plan: Child Care Center CCL-5001
Child Care License Designee CCL-5003
Certification of School Building Fire Safety Provisions CCL-5043
Self-Certification of Transportation Provisions for Centers CCL-5044
Volunteer Certification for Field Trip Transportation CCL-5046
Playground Inspection Certification Summary CCL-5047
Licensing Notebook Summary Sheet - CCL-5052
Parent Notification of the Licensing Notebook CCL-5053
Request for Modification of the Terms of the License - CCL-5054
Multiple Occupancy Documentation for Child Care Centers – CCL- 2118
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Child Care Center Orientation Resources
Module 3, Staffing:
- 3.4 Child Care Center Information and Policy Acknowledgement Form - Word
- 3.5 Center Training (R 400.8216 and R 400.8216a) Checklist - PDF
Module 4, Communication and Notifications:
Module 6, General Health and Safety:
- 6.2 Safe and Healthy Diaper Changing - PDF
- 6.6 Fire Emergency Plan - PDF
- 6.6 Accident Injury Plan - PDF
- 6.6 Accident Injury Plan - Word
- 6.6 Tornado Emergency Plan - PDF
- 6.6 Tornado Emergency Plan - Word
- 6.6 Be Prepared for a Winter Storm - PDF
- 6.6 Be Prepared for a Power Outage - PDF
- 6.6 Gas Leak, Water Main Break, Winter Storm Emergency Plans - PDF
- 6.6 Gas Leak, Water Main Break, Winter Storm Emergency Plans - Word
- 6.6 Bomb Threat, Power Outage, or Suspicious Packages Emergency Plans - PDF
- 6.6 Bomb Threat, Power Outage, or Suspicious Packages Emergency Plans - Word
- 6.6 Sample Missing Child Emergency Protocol - PDF
- 6.6 Sample Missing Child Emergency Protocol - Word
- 6.6 Continuing Operations During and After a Disaster Sample Plan - Word
Module 7, Program and Care:
Module 9, Food Safety and Nutrition:
Module 10, Transportation Permission Form
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Checklists - Homes and Centers
- pdfFamily and Group Child Care Home Compliance Record - BCAL-4601
- docPreparing for Your License Renewal Fire Safety Inspection - BCAL-5048
- pdfChild Care Center Compliance Record, Part 1. General Provisions - BCAL-1888
- docChild Care Center Compliance Record, Part 2. Environmental Health Provisions - BCAL-4668
- pdfChild Care Center Compliance Record, Part 3. Fire Safety Provisions - BCAL-0722
- docChild Care Center Compliance Record, Part 4. Transportation Provisions - BCAL-1891
- pdfChild Care Center Compliance Record, Part 5. Swimming Provisions - BCAL-1890
- docChild Care Home Record Requirements - BCAL-5040
- pdfChild Care Center Record Requirements - BCAL-5041
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Renewal Applications