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District of Columbia Child Care Information for Providers Forms

• Application to Establish a Child Development Center
  For the Child Care Provider this is an Application to Establish, Operate, and Maintain a Child Development Center
• Department of Health Clean Hands Certification*
  For the Child Care Provider this is a Certification for the "Clean Hands Before Receiving a License or Permit Act of 1996". This Certification states that the applicant does not owe $100.00 or more as a result of the following: Fines, penalties or interest assessed pursuant to the Litter Control Administration Action of 1985, effective March 25, 1986 (D.C. Law 6-100; D.C. Code § 6-2901 et seq.);
• Incorporation Form*
  For the Child Care Provider this is an application for Child Development Facility licensure, who are incorporated or who are with an association, must complete the following information pursuant to Title 29 DCMR, Chapter 3, Child Development Facilities, Section 302.2(a).
• Reference Letter*
  For the Child Care Provider this is a Reference Letter to be used duirng the application and licensing process.
• Child Care Employee Appointment, Promotion or Separation Notification*
  For the Child Care Provider this is a form to be completed and sent to the Child and Residential Facility Division for each newly hired (appointed) staff, staff promotion, or seperation in your facility.
• Child Development Facility Employee Information*
  For the Child Care Provider this is a Health Information Form to be completed by an Emplyee working at the Childcare Facility.
• Registration Record for Child Receiving Care Away From Home
  For the Childcare Provider this is a form to be completed for children that are cared for outside of the home.
• Authorization for Childs Emergency Medical Treatment
  For the Child Care Provider this form is to be completed for Emergency Medical Treatment by a Hospital or Health Provider requested by parents. This form also allows for the Childcare Facility to take the child for treatment if the parent(s) can not be contacted.
• Emergency Contingency Plan
  For the Childcare Provider this is a form to be completed for an Emergency Contigency Plan in the event of an emergency closure, due to any reason that will prohibit the facility from caring for the children temporarily.
• Child Development Center Licensing Requirements - 2 pages*
  For the Childcare Providers this is a checklist of all steps needed to complete the licensing/permit process to open a Childcare facility.

Chick here to view Federal Child Care Information for Providers Forms