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Child Care Forms & Publications Form Search by Title, Form Number or Language - New Publication Search by Title, Number or Language - New Numerical Listing Form No. Date Title N/A 08/12 Policy Sample - Family Child Care Centers - PDF / Word DCF-F-CFS0052 12/08 Vehicle Safety Inspection DCF-F-CFS0053 08/12  Staff Record - Child Care Centers DCF-F-CFS0053A 12/08 Staff Continuing Education Record - Child Care Centers - PDF / Word DCF-F-CFS0054 02/09 Staff Health Report - Child Care Provider - PDF / Word DCF-F-CFS0055 01/13 Incident Report - Child Care Centers - PDF / Word DCF-F-CFS0056 12/08 Transportation Permission - Child Care Centers - PDF / Word DCF-F-CFS0057-E 04/10 Informed Consent for Observation or Testing by an Outside Agency - Child Care Centers DCF-F-CFS0058 02/09 Field Trip or Other Activity Notification/Permission - Child Care Centers - PDF / Word DCF-F-CFS0059-E 08/10 Authorization to Administer Medication - Child Care Centers - PDF / Word DCF-F-CFS0060-E 05/10  Child Health Report - Child Care Centers DCF-F-CFS0061-E 01/09 Intake for Child Under 2 Years - Child Care Centers DCF-F-CFS62 02/09 Child Care Enrollment - PDF / Word DCF-F-CFS0063 10/12  Licensing Checklist - Group Child Care Centers DCF 251 DCF-F-CFS0065 12/12 License Application - Group Child Care Centers DCF-P-0066 04/13 Entry-Level Training Requirements as of January 1, 2009 - Group Child Care Centers DCF-F-CFS0067 05/12 License Application - Family Child Care Centers DCF-F-CFS0069 02/13  Licensing Checklist - Family Child Care Centers DCF 250 DCF-F-CFS0070 04/11 Licensing Checklist - Day Camps DCF-F-CFS0078 01/09 Child Care Staff-to-Child Ratio Worksheet Group Child Care Centers - PDF / Word DCF-P-PFS0101 06/10 It Shouldn't Hurt to be a Child DCF-F-CFS0104-E 09/09 Alternate Arrival / Release Agreement - Child Care Centers - PDF / Word DCF-F-CFS0297-E 10/09 Request for Exception - PDF / Word DCF-F-CFS460 04/12 Safety and Emergency Response Documentation - Family Child Care Centers DCF-P-PFS503 09/11 Your Child Care - Is It Legal? DCF-F-CFS0543 02/09 Fire Safety and Emergency Response Documentation - Group Child Care Centers DCF-P-PFS0602 11/10 Applicant/Licensee Rights and Responsibilities DCF-F-CFS0782 03/09 License Application - Day Camps for Children DCF-F-CFS1675 12/12  Child Record Checklist - Child Care Centers - PDF / Word DCF-F-CFS1675A 03/11 Staff Record Checklist - Group Child Care Centers DCF-F-CFS2022 04/12 Ordering Information - Inquiry Packets DCF-F-CFS2026 04/09 Staff Orientation Checklist - Group Child Care Centers - PDF / Word DCF-F-CFS2027 06/09 Volunteer Training Confirmation - Group Child Care Centers DCF-F-CFS2048 01/09 Policy Checklist - Group Child Care Centers DCF-F-CFS2051 05/12 Staff Record Checklist - Family Child Care Centers - PDF / Word DCF-F-CFS2114 04/13 Continuing Education Record - Independent Reading / Video Viewing - PDF / Word DCF-F-CFS2241 05/12  Initial Licensing Checklist - Family Child Care Centers - PDF / Word DCF-F-CFS2242 12/12 Initial Licensing Checklist - Group Child Care Centers DCF-F-CFS2255 05/12 Staff Orientation Checklist - Family Child Care Centers - PDF / Word DCF-F-CFS2261-E 05/10 Caregiver Background Checks Substantially Related Investigation Report - PDF / Word DCF-F-CFS2344 12/12 Building Inspection Report - Child Care Centers DCF-F-CFS2345 03/09 Health History and Emergency Care Plan - PDF / Word DCF-F-CFS2356 08/12 Policy Checklist - Family Child Care Centers DCF-F-2405 04/09 Pre-Camp Training Documentation - Day Camps - PDF / Word DCF-F-2409 03/09 Policy Checklist - Day Camps DCF-F-2424 04/09 Counselor-to-Child Ratio Worksheet - Day Camps for Children - PDF / Word DCF-P-2436 01/12 Your Guide to Regulated Child Care DCF-F-CFS2438 01/09 Daily Attendance Record - Child Care Centers - PDF / Word DCF-F-2452 04/09 Child Record Checklist - Day Camps for Children - PDF / Word DCF-F-2453 04/12 Staff Record Checklist - Day Camps for Children - PDF / Word DCF-F-2455 04/09 Counselor-to-Child Ratio While Swimming Worksheet - Day Camps for Children - PDF / Word DCF-P-2456 05/10 Instructions for Obtaining Forms - Day Camps for Children DCF-F-2465 08/09 Staff-to-Child Ratio While Swimming Worksheet - Group and Family Child Care DCF-F-2541-B 05/12 Residents & Minor Caregivers - Licensed Group Child Care DCF-F-2541-C 05/12 Residents & Minor Caregivers - Licensed Day Camp DCF-F-2541-E 05/12 Household Members & Minor Caregivers - Licensed Family Child Care DCF-P-2560 08/10 Caregiver Background Checks - Summary of Employee Process DCF-P-2562 08/10 Potential Barriers to Obtaining a Child Care Center License DCF-P-2563 01/11 Email Subscription Service BECR DCF-F-2569 09/10 Permission to Deduct Caregiver Background Check Fees from WI Shares Subsidy Payments PDF / Word DCF-P-2570 05/12 Licensed Group Child Care CBC Requirements for WI DCF 251 DCF-P-2571 05/12 Licensed Day Camp Child Care CBC Requirements for WI DCF 252 DCF-P-2572 05/12 Licensed Family Child Care CBC Requirements for WI DCF 250 DCF-F-2590 12/12 YoungStar Contract - Family Provider DCF-F-2591 02/13 YoungStar Contract - Group Center DCF-F-2752 02/13 YoungStar Contract - School-Age Programs DCF-P-2693 03/12 Caregiver Background Check Process - Brief Summary for Licensed Child Care Centers DCF-P-PFS3038 12/12 Instructions for Obtaining Forms - Group & Family Child Care Centers DCF-P-PFS3064 06/10 Frequently Asked Questions - Caregiver Background Check Requirements for Child Care Centers DPH-4020L 07/12 Student Immunization Record DCF-P-PFS4085 06/10 Collaborative Child Care Programs - Technical Assistance Tool DCF-P-PFS4088 04/10 Use of 10+ Passenger Vans To Transport Children To and From Schools DCF-P-PFS4091 06/12 Entry-Level Non-Credit Courses for Licensed Child Care DCF-F-4099 04/12 Instructions for Obtaining Licensing Rule Books, Annotated Rule Books and Commentary Manuals DOA-6448 11/12  Taxpayer Identification Number (TIN) Verification (W-9) F-44192 09/08 Day Care Immunization Record (DPH-4192) F-82064A 02/13 Background Information Disclosure (HFS-64A)

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