Quality Assurance Division
Child Care Licensing
List of Forms
- Accident / Injury Report
- Activity Schedule/Written Plan
- Center Staff Master List
- Change of Name/Address/Ages Application
- Change of Status Application
- Child Abuse/Neglect Intake Form
- Complaint Intake Form Directions
- Complaint Intake Form for Daycares
- Egress Window Requirements
- Emergency Contact Information
- Employee Cover Sheet
- Family / Group Staff Master List
- Fingerprint Release of Information
- Fire Safety Record and Evacuation Plan
- Floor Plan/Square Footage Report
- Infant Feeding Schedule
- Insurance Verification Form
- Medication Administration Log
- Medication Authorization Form
- Medication Error/Incident Report
- Menu Form
- New Application (Center)
- New Application (Family/Group)
- Non_Ingestible OTC Medication Authorization
- Overlap Care
- Pediatric Health Statement
- Provider Staff Role Types
- Release of Driving Records (Non-extended Center Only)
- Release of Information
- Renewal Application (Center)
- Renewal Application (Family/Group)
- Special Needs Heath Care Plan
- Statement of Health Form
- W-9


