Washington Daycare and Child Care Forms
Licensing Forms & Documents for Providers
General Licensed Child Care Forms School-Age and Center Provider Forms Family Home Provider Forms News and information
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General Licensed Child Care Forms
Background Check Form
Background check form for child care workers.
Background Check Form File Format: Adobe Acrobat (PDF) [49k]
Background Check Form (Spanish) File Format: Adobe Acrobat (PDF) [51k]
Background Check Form File Format: Microsoft Word (DOC) [253k]
Background Check Form (Spanish) File Format: Microsoft Word (DOC) [271k]
Certificate of Immunization Status Form
Washington State Department of Health Certificate of Immunization Status form.
Certificate of Immunization Status Form (English) File Format: Adobe Acrobat (PDF) [100k]
Certificate of Immunization Status Form (Spanish) File Format: Adobe Acrobat (PDF) [177k]
Child Care Agreement
Financial agreement.
Child Care Agreement File Format: Adobe Acrobat (PDF) [26k]
Child Care Agreement (Spanish) File Format: Adobe Acrobat (PDF) [31k]
Child Care Agreement File Format: Microsoft Word (DOC) [185k]
Child Care Agreement (Spanish) File Format: Microsoft Word (DOC) [188k]
Child Care Registration
Child Care Registration Form.
Child Care Registration File Format: Adobe Acrobat (PDF) [41k]
Child Care Registration (Spanish) File Format: Adobe Acrobat (PDF) [48k]
Child Care Registration File Format: Microsoft Word (DOC) [219k]
Child Care Registration (Spanish) File Format: Microsoft Word (DOC) [210k]
Daily Attendance Records
Attendance record form for child care facilities.
Daily Attendance Records File Format: Adobe Acrobat (PDF) [244k]
Daily Attendance Records (Spanish) File Format: Adobe Acrobat (PDF) [28k]
Daily Attendance Records File Format: Microsoft Word (DOC) [81k]
Daily Attendance Records (Spanish) File Format: Microsoft Word (DOC) [257k]
Fire Safety Record
Fire Safety Record and Evacuation Plan.
Fire Safety Record File Format: Adobe Acrobat (PDF) [202k]
Fire Safety Record (Spanish) File Format: Adobe Acrobat (PDF) [220k]
Fire Safety Record File Format: Microsoft Word (DOC) [208k]
Fire Safety Record (Spanish) File Format: Microsoft Word (DOC) [210k]
Injury/Incident Report
Child injury form.
Injury/Incident Report File Format: Adobe Acrobat (PDF) [84k]
Injury/Incident Report (Spanish) File Format: Adobe Acrobat (PDF) [41k]
Injury/Incident Report File Format: Microsoft Word (DOC) [198k]
Injury/Incident Report (Spanish) File Format: Microsoft Word (DOC) [77k]
Reconsideration Request Form
Form to request a reconsideration.
Reconsideration Request Form File Format: Adobe Acrobat (PDF) [33k]
Reconsideration Request Form File Format: Microsoft Word (DOC) [184k]
School Based and Military Certification for Payment Only Request Form
Form to request certification for payment only.
School Based and Military Certification for Payment Only Request Form File Format: Adobe Acrobat (PDF) [50k]
School Based and Military Certification for Payment Only Request Form File Format: Microsoft Word (DOC) [170k]
Tribal Certification Request Letter Template
Form to request Tribal certification for payment only.
Tribal Certification Request Letter Template File Format: Adobe Acrobat (PDF) [6k]
Tribal Certification Request Letter Template File Format: Microsoft Word (DOC) [41k]
School-Age and Center Provider Forms
Child Care Center Director/Program Supervisor Notice of Change
Child care center or school age director/program supervisor notice of change.
Child Care Center Director/Program Supervisor Notice of Change File Format: Adobe Acrobat (PDF) [56k]
Child Care Center Director/Program Supervisor Notice of Change File Format: Microsoft Word (DOC) [184k]
Child Care Center Feasibility Checklist
Licensing checklist form for child care centers.
Child Care Center Feasibility Checklist File Format: Adobe Acrobat (PDF) [109k]
Child Care Center Feasibility Checklist File Format: Microsoft Word (DOC) [217k]
Child Care Center Licensing Checklist
Licensing checklist form for child care centers.
Child Care Center Licensing Checklist File Format: Adobe Acrobat (PDF) [217k]
Child Care Center Licensing Checklist File Format: Microsoft Word (DOC) [681k]
Child Care Center Monitoring Checklist
Monitoring checklist form for child care centers.
Child Care Center Monitoring Checklist File Format: Adobe Acrobat (PDF) [217k]
Child Care Center Monitoring Checklist File Format: Microsoft Word (DOC) [681k]
Center and School-Age Licensing Application
Licensing Application form for Centers & School-age facilities. You must attend DEL orientation before submitting a licensing application.
Center and School-Age Licensing Application File Format: Adobe Acrobat (PDF) [223k]
Center and School-Age Licensing Application File Format: Microsoft Word (DOC) [570k]
Center and School-Age Application for Employment
Application for Employment in a licensed child care facility.
Center/SA Application for Employment File Format: Adobe Acrobat (PDF) [174k]
Center/SA Application for Employment File Format: Microsoft Word (DOC) [360k]
Center File Review Checklist
File review checklist form for child care centers.
Center File Review Checklist File Format: Adobe Acrobat (PDF) [107k]
Center File Review Checklist File Format: Microsoft Word (DOC) [202k]
Center Probation Notification Letter to Parents
Letter to inform parents the center is operating with a probationary child care license under the following conditions.
Center Probation Notification Letter to Parents File Format: Adobe Acrobat (PDF) [35k]
Center Probation Notification Letter to Parents File Format: Microsoft Word (DOC) [38k]
School-Age Licensing Checklist
Licensing Checklist form for School-age Programs.
School-Age Licensing Checklist File Format: Adobe Acrobat (PDF) [210k]
School-Age Licensing Checklist File Format: Microsoft Word (DOC) [480k]
School-Age Monitoring Checklist
Licensing Checklist form for School-age Programs.
School-Age Monitoring Checklist File Format: Adobe Acrobat (PDF) [210k]
School-Age Monitoring Checklist File Format: Microsoft Word (DOC) [480k]
Family Home Provider Forms
Family Home Liability Insurance Exemption
A form regarding insurance status.
Insurance Notification File Format: Adobe Acrobat (PDF) [8k]
Insurance Notification File Format: File Format: Microsoft Word (DOC) [24k]
Family Home Licensing Application
Licensing Checklist form for Family Home Child Care. You must attend DEL orientation before submitting a licensing application.
Licensing Application form for Family Home Child Care File Format: Adobe Acrobat (PDF) [250k]
Licensing Application form for Family Home Child Care (Spanish) File Format: Adobe Acrobat (PDF) [283k]
Licensing Application form for Family Home Child Care File Format: Microsoft Word (DOC) [280k]
Licensing Application form for Family Home Child Care (Spanish) File Format: Microsoft Word (DOC) [279k]
Family Home Licensing Checklist
Licensing Checklist form for Family Home Child Care.
Family Home Licensing Checklist File Format: Adobe Acrobat (PDF) [250k]
Family Home Licensing Checklist (Spanish) File Format: Adobe Acrobat (PDF) [283k]
Family Home Licensing Checklist File Format: Microsoft Word (DOC) [280k]
Family Home Licensing Checklist (Spanish) File Format: Microsoft Word (DOC) [279k]
Family Home Monitoring Checklist
Monitoring Checklist form for Family Home Child Care.
Family Home Monitoring Checklist File Format: Adobe Acrobat (PDF) [181k]
Family Home Monitoring Checklist (Spanish) File Format: Adobe Acrobat (PDF) [189k]
Family Home Monitoring Checklist File Format: Microsoft Word (DOC) [280k]
Family Home Monitoring Checklist (Spanish) File Format: Microsoft Word (DOC) [279k]
Family Home Permission Authorization
Parent/guardian permission authorization form for family home child care.
Family Home Permission Authorization File Format: Adobe Acrobat (PDF) [37k]
Family Home Permission Authorization (Spanish) File Format: Adobe Acrobat (PDF) [25k]
Family Home Permission Authorization File Format: Microsoft Word (DOC) [42k]
Family Home Permission Authorization (Spanish) File Format: Microsoft Word (DOC) [166k]
Family Home Probation Notification Letter to Parents from Provider
Parent/guardian permission authorization form for family home child care.
Probation Notification Letter File Format: Adobe Acrobat (PDF) [35k]
Probation Notification Letter File Format: Microsoft Word (DOC) [34k]
Family Home Provider/Assistant Resume Form
Provider/assistant resume form for family home child care.
Family Home Provider/Assistant Resume Form File Format: Adobe Acrobat (PDF) [55k]
Family Home Provider/Assistant Resume Form (Spanish) File Format: Adobe Acrobat (PDF) [38k]
Family Home Provider/Assistant Resume Form File Format: Microsoft Word (DOC) [99k]
Family Home Provider/Assistant Resume Form (Spanish) File Format: Microsoft Word (DOC) [243k]
Family Home Request to Change Capacity
Family child care capacity change request form.
Family Home Request to Change Capacity File Format: Adobe Acrobat (PDF) [158k]
Family Home Request to Change Capacity (Spanish) File Format: Adobe Acrobat (PDF) [47k]
Family Home Request to Change Capacity File Format: Microsoft Word (DOC) [228k]
Family Home Request to Change Capacity (Spanish) File Format: Microsoft Word (DOC) [223k]
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