Child Care Provider Information

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 Child Care Admission and Arrangements (DHS website)

​2. Family Child Care Allergy Information Form (DHS website)

3. Family and Group Family Day Care Rule Summary For Parents (25 KB)

4.  Immunization Record (181 KB) 
5.  Permission To Administer (81 KB)
6.  Permission To Administer Prescription Medication (14 KB)
7.  Reporting Abuse Policy (133 KB)

Background Check Forms

1.  Consent Form (28 KB)

2.  Consent Form for New Household Member Ages 13 and Older and Current Household Members Turning Age 13 (20 KB)

3.  Consent Form for Substitutes Helpers and Employees of Child Care Facilities (49 KB)

Change of Premise

1.  Family Child Care Monitoring Questionnaire (91 KB)

2.  Family Systems Application  (120 KB) 

3.  Floor and Escape Plan (257 KB)

General Information & Forms

​1.  Annual Training Requirements (28 KB)

​2.  Bleach Alternative Checklist (106 KB)

3.  Child/Adult Ratios and Age Restrictions (12 KB)

4.  Child Care Licensing Contact Information (22 KB)

5.  Crib Inspection Monthly Form (DHS 16_178540)

6.  Emergency Numbers (20 KB)

7.  Family Child Care Liability Insurance Notice to Parents

8.  Fire and Storm Drill Log (97 KB)

9.  Food Programs (MN Department of Education)

10. Guidelines for Developing a Provider Policy (25 KB) 

11. Incident Report Form (23 KB)

12. Infant Less Than Six Months of Age Regularly Rolling Over (104 KB)

​13.  Initial Requirements for New Second Adult Caregivers, Substitutes and Helpers (19 KB)

14. Licensing Fees (17 KB)

15. Parental Consent for Swaddling an Infant (88 KB) 

16. Physician Directive for Infant Sleep Position (41KB)

17. Physician's Report (47 KB)

18. Preschool Programs (12 KB)

19. Training and Tracking Information Form (92 KB)

20. Variance Request.pdf (152 KB) 

Wading Pools & Swimming Pools
Provider Information:
1.  Wading Pool Best Practices - Family Child Care

Parent Information:

1.  Wading Pool Risks - Family Child Care

2.  Swimming Pool Risks - Family Child Care 

3.  Wading Pool Permission Form - Family Child Care

4.  Swimming Pool Permission Form - Family Child Care