Licensed & Group Day Care

Application Packet Forms

  1. CCL 201 Application for a NEW LDCH and GDCH (PDF)
  2. CCL 201a Instructions for New LDCH GDCH (PDF)
  3. CCL 201b New app checklist LDCH GDCH Commercial Setting (PDF)
  4. CCL 201c Site Approval Home Commercial Setting (PDF)
  5. CCL 202 Renewal App LDCH GDCH (PDF)
  6. CCL 303 Closure Notification (PDF)
  7. CCL 400 Orientation Checklist for LDCH and GDCH (PDF)
  8. CCL 002 Background and Registry Check (PDF)
  9. CCL 002 Background and Registry Check Spanish (PDF)
  10. CCL 002a LDCH-GDCH Affiliate Roles (PDF)
  11. CCL 002a LDCH-GDCH Affiliate Roles Spanish (PDF)
  12. CCL 028a Critical Incident Report (PDF)
  13. Critical Incident Reporting FAQs (PDF)
  14. Corrective Action Plan Provider Instructions (PDF)
  15. Corrective Action Plan Template (PDF)

Supplemental Forms in Application Packet

  1. CCL 005 Yearly Mechanical Safety Check (PDF)
  2. CCL 005 Yearly Mechanical Safety Check Spanish (PDF)
  3. CCL 009 Health Assessment, 16 and Older (PDF)
  4. CCL 009 Health Assessment, 16 and Older Spanish (PDF)
  5. CCL 010 Authorization for Emergency Medical Care (PDF)
  6. CCL 010 Authorization for Emergency Medical Care Spanish (PDF)
  7. CCL 025 Diapering of Children in Child Care (PDF)
  8. CCL 025 Diapering of Children in Child Care Spanish (PDF)
  9. CCL 026 Short-Term Medication Authorization (PDF)
  10. CCL 026 Short-Term Medication Authorization Spanish (PDF)
  11. CCL 027 Long-Term Medication Authorization (PDF)
  12. CCL 027 Long-Term Medication Authorization Spanish (PDF)
  13. CCL 029 and 029a Child Medical Record, Immunization History, and Health Assessment (PDF)
  14. CCL 029 and 029a Child Medical Record, Immunization History, and Health Assessment Spanish (PDF)
  15. CCL 034 Parental Permission, Off-Premise Trips (PDF)
  16. CCL 034 Parental Permission, Off-Premise Trips Spanish (PDF)
  17. CCL 035 Parental Permission, Off-Premise, Group Trips (PDF)
  18. CCL 035 Parental Permission, Off-Premise, Group Trips Spanish (PDF)
  19. CCL 203 Licensed Group Day Care Homes Self-Audit Survey Tool (PDF)

Supplemental Forms not in Application Packet

  1. CCL 031 Request for Exception (PDF)
  2. CCL 031 Request for Exception Spanish (PDF)
  3. CCL 039 Request for Family Foster Home Exception (PDF)
  4. CCL 032 Request for Amendment (PDF)
  5. CCL 032 Request for Amendment Spanish (PDF)
  6. CCL 205 Schedule of Enrollment (PDF)

Informational Documents

  1. Child Care Initial and Annual Surveys (PDF)
  2. Child Care Initial and Annual Surveys Spanish (PDF)
  3. Child Care Complaint Survey Information (PDF)
  4. Child Care Complaint Survey Information Spanish (PDF)
  5. Provider Guidance for Family Foster Home Exceptions (PDF)
  6. CCL 006 Reporting Suspected Abuse and Neglect (PDF)
  7. CCL 006 Reporting Suspected Abuse and Neglect Spanish (PDF)
  8. CCL 008 Licensing of Child Care (PDF)
  9. CCL 011 Recommended Health Supervision (PDF)
  10. CCL 012 Behavior and Guidance (PDF)
  11. CCL 012 Behavior and Guidance Spanish (PDF)
  12. CCL 033 Comparing Licensed Day Care Homes (PDF)
  13. CCL 036 Selecting Child Care Guide for Parents (PDF)
  14. CCL 037 Guidelines for Exclusion (PDF)
  15. CCL 037 Guidelines for Exclusion Spanish (PDF)
  16. CCL 208 Guidelines for Training LDCH-GDCH (PDF)

Other Resources