| The information sheets and forms are Adobe PDF documents or links to the MN Department of Human Services web pages and will open in a separate window. |
Admissions Packet |
| 1. Family Day Care Admission and Arrangements (DHS-1715 Form) |
| 2. Emergency Authorization |
| 3. Permission To Administer |
| 4. Permission To Administer Prescription Medication |
| 5. Family and Group Family Day Care Rule Summary For Parents (DHS-6367 Form) |
| 6. Immunization Record |
| 7. Reporting Abuse Policy |
Paperwork For Substitutes |
| 1. Background Check Form For Helpers and Substitutes |
| 2. SIDS Packet |
| 3. Never Shake a Baby |
| 4. Shaken Baby Syndrome Test (12 KB PDF) |
| 5. Shaken Baby Video Link (DHS) |
General Information & Forms |
| Alternate Sleep Position Form 5876 DHS |
| Background Check Tracking Form - (17 KB PDF) |
| Background Check Consent Form Providers and Family (18 KB PDF) |
| Background Check Form For Helpers and Substitutes and Other Required Paperwork (20 KB PDF) |
| Child/Adult Ratios and Age Restrictions (12 KB PDF) |
| Contacts/Email Addresses/Crisis Line (after hours)/Child Protection (20 KB PDF) |
| Crib Inspection Form (DHS-4927-ENG) - (242 KB PDF) |
| Day Care Reports - (16 KB PDF) |
| Emergency Numbers - (20 KB PDF) |
| Fire Drill Log - (16 KB PDF) |
| Food Programs - (24 KB PDF) |
| Landlord Permission - (12 KB PDF) |
| Licensing Fees |
| Preschool Programs (12 KB PDF) |
| Provider Policies/Contract Sample (20 KB PDF) |
| Provider Policy Sample |
| Policy/Contract Guidelines- (12 KB PDF) |
| State Statutes Revised - (42 KB PDF) |
| Trampoline Permission Form |
| Variance Enrollment Form (12 KB PDF) |
| Variance Parent Statement (11 KB PDF) |
| Variance Request (10 KB PDF) |
| Wading Pools - DHS (KB PDF) |
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