Quality Assurance Division
Child Care Licensing
Family/Group New Application Packet
The following forms/information are included in a New Application Packet for Family/Group Facilities:
- New Family / Group Application Checklist (Print First)
- New Application (Family/Group)
- Application for Overlap Care
- W-9
- Insurance Verification Form
- Fire Safety Record and Evacuation Plan
- Menu Form
- Activity Schedule/Written Plan
- Floor Plan/Square Footage Report
- Release of Information
- Statement of Health Form
Additional Information for New Applicants:
- Child/Infant Child Care Regulations
- Family / Group Staff Master List
- General Child Care Information
- Information Regarding Medication Administration in Child Care
- New Provider Pamphlet
- Out of State Background Checks
- Provider Staff Role Types
- Sign In and Out Sheet
- Tribal Background Checks
- Egress Window Requirements
All Family/Group New Application Packets should be submitted to:
Mary Stukaloff
PO Box 202953
Helena MT 59620-2953
(406) 444-9460
