Childcare Checklist

Licensed child care providers are required to maintain accurate records and documentation for each child enrolled in the facility. Use the checklist below to ensure that you have the complete set of forms in the personal file of every child under your care.

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Childcare Registration Form (Sample)
This childcare registration form template allows capturing all the essential application information for each child in your care. You can collect child's information such as name, address, sex, hours of child care required, parents' information, emergency contact information, medical information by using this childcare registration form template.
All About the Child Form (Sample)
Form to capture all information about the child.
Individual Infant Sleeping Plan (LIC 9227)
Form for Infants with an Individual Infant Sleeping Plan.
Consent for Emergency Medical Treatment (LIC 627)
This document gives you permission by the parent to seek emergency medical or dental care for their child if needed.
Acknowledgement of Receipt of Licensing Reports (LIC 9224)
Applicable if information about the child care facility's compliance with licensing rules is requested by the parent.
Parent Notification, Additional Children in Care (LIC 9150)
This document is required if you plan to care for more than 6 children for a Small Family Child Care Home, or more than 12 for a Large Family Child Care Home.
California School Immunization Records (PM 286)
For every infant, toddler, or preschool age child admitted into a Family Child Care Home, the provider must maintain current immunization records on the PM 286.
Affidavit Regarding Liability Insurance (LIC 282)
This form is required to be signed by each parent of a child in care if you do not have either liability insurance or a bond.
Child's Pre-admission Health History – Parent's Report (LIC 702)
This health evaluation form is required to be submitted by each parent of a child in care upon enrollment.
Identification and Emergency Information (LIC 700)
This form must be kept for each child in care and identifies whom to call in an emergency
Physician's Report - Child Care Centers (LIC 701)
This form is required to be submitted by each parent of a child in care upon enrollment to capture the child's health information.
Notification of Parents' Rights (LIC 995A)
This form must be given to each parent at the time a child is accepted for care, along with the LIC 995E.
Nebulizer Care Consent / Verification (LIC 9166)
Before a child care licensee or staff person can administer inhaled medication to a child in care, this form must be completed and filed in the child's record and in the personnel file. A separate form must be filled out for each person who administers inhaled medication to the child.
Caregiver Background Check Process (LIC 995E)
This form must be given to each parent at the time a child is accepted for care, along with the LIC 995A.
Personal Rights - Community Care Facilities, Child Care Facilities (LIC 613A)
This is a document signed by a child's parent, guardian, or representative in order to acknowledge that a child's personal rights are observed and respected while the child is receiving services from a child care center.
Family Child Care Consumer Awareness Information (LIC 9212)
This form must be given to the parents of each child in care.
Parent Consent for Administration of Medications and Medication Chart (LIC 9221)
This form must be completed and signed by the authorized representative of the child for both prescription and nonprescription.