Forms for Child Care Providers
The documents listed on the Child Care Productions site are available as PDF (portable document format) files
. To be able to read these files, please download a free copy of Adobe Acrobat Reader.
Forms needed for Family Day Care providers:
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LIC 282 Affidavit Regarding Liability Insurance for Family Day Care Home (Required if provider does not have Family Child Care Liability Insurance)
LIC 9150 Parent’s Rights (required)
LIC 508 Criminal Record Statement
LIC 613A Personal Rights (required)
LIC 627 Consent for Emergency Medical Treatment (required)
LIC 700 Identification and Emergency Information (required)
LIC 702 Child’s Preadmission Health History (required)
LIC 995 Parent’s Right’s (required)
LIC 9040 Child Care Facility Roster (required)
LIC 9052 NOTICE Employee Rights (required if a large facility)
Pamphlets for parents/guardians(Need to be given when child is enrolled)
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PUB 72 Family Child Care- What are Parent’s Responsibilities
PUB 270 Never Shake a Baby
PUB 300 Reduce the Risk of Sudden Infant Death Syndrome
Food Program
Child Care Job Bank
CCCC Training Calendar
Local Investment In Child Care (LINCC)
Resource Lending Library
Resource & Referral (R&R)
License-Exempt Provider Program
