School Age Drop-In Program

The Child Care Licensing (CCL) 002 Background and Registry Check form is to be submitted to the Kansas Department of Health and Environment (KDHE). Additional documentation is required.

Immunizations

View School and Child Care Immunization Information.

Application Packet Forms

  1. CCL 303 Closure Notification (PDF)
  2. CCL 801 DIP Application (PDF)
  3. CCL 801a Instructions DIP (PDF)
  4. CCL 801b Application Checklist DIP (PDF)
  5. CCL 002 Background and Registry Check (PDF)
  6. CCL 002 Background and Registry Check Spanish (PDF)
  7. CCL 002a DIP Affiliate Roles (PDF)
  8. CCL 002a DIP Affiliate Roles Spanish (PDF)
  9. CCL 028a Critical Incident Report (PDF)
  10. Critical Incident Reporting FAQs (PDF)
  11. Corrective Action Plan Provider Instructions (PDF)
  12. Corrective Action Plan Template (PDF)

Supplemental Forms in Application Packet

  1. CCL 002 Background and Registry Check (PDF)
  2. CCL 002 Background and Registry Check Spanish (PDF)
  3. CCL 002a DIP Affiliate Roles (PDF)
  4. CCL 002a DIP Affiliate Roles Spanish (PDF)
  5. CCL 010 Authorization for Emergency Medical Care (PDF)
  6. CCL 010 Authorization for Emergency Medical Care Spanish (PDF)
  7. CCL 203 Drop In Program Self-Audit Survey Tool (PDF)
  8. CCL 356 Application for Program Director Approval (PDF)
  9. CCL 356 Application for Program Director Approval Spanish (PDF)
  10. CCL 357 Health Status for 14 years and Older (PDF)
  11. CCL 358 Child Health History (PDF)

Supplemental Forms not in Application Packet

  1. CCL 031 Request for Exception (PDF)
  2. CCL 031 Request for Exception Spanish (PDF)
  3. CCL 032 Request for Amendment (PDF)
  4. CCL 032 Request for Amendment Spanish (PDF)
  5. CCL 360 Inquiry Regarding Licensure SAP (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. CCL 006 Reporting Suspected Abuse and Neglect (PDF)
  6. CCL 006 Reporting Suspected Abuse and Neglect Spanish (PDF)
  7. CCL 008 Licensing of Child Care (PDF)
  8. CCL 036 Selecting Child Care Guide for Parents (PDF)
  9. CCL.037 Guidelines for Exclusion of children who are ill (PDF)