Licensing forms

Forms for background studies

Initial Adam Walsh background study ID form

Consent for release of information from FBI national crime information databases to private child placing agency (required for background studies from private child placing agencies only)

Supplement to Application Form – DHS 3324 (CFC, AFC, FADS)

Consent for release of information from child abuse and neglect registry when background study subject resided outside Minnesota within last five years

Forms for child care centers

http://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=id_028228

Child Care Center Injury/Incident Report Form (3-10)

Child Care Center license application form (12-06)

Child care immunization record (4-10)

Document list (3-10)

Experienced aide report (11-07)

Floor plan (1-07)

Guidelines for Policies & Procedures (2-08)

Health care summary (1-01)

Infant equipment and supplies form (9-02)

Maltreatment of Minors mandated reporting policy form (2-08)

Monthly Crib Safety Inspection Form (1-07)

Parent Directive for Infant Sleep Position (7-09)

Personnel information form (4-08)

Preschool equipment and supplies form (9-02)

School age equipment and supplies form (4-10)

Separation report (7-09)

Staff in-service training record (4-08)

Staffing patterns (1-01)

Summary of personnel information (3-10)

Toddler equipment and supplies form (9-02)

Unqualified substitute report (1-01)

Variance request (6-07)

More Daycare Resources

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• Daycare Licensing Laws and Regulations