Wisconsin Department of Children and Families

Protecting Children, Strengthening Families, Building Communities

 

 

Child Care Certification Forms and Publications

There are a number of useful application forms and other documents for certified child care providers. Use the two searchable tables below to locate Certified Family Child Care Application Forms and Certified Operator Forms. If you have questions about any of these forms, please contact your local agency certifier.

Other forms, publications that may be of interest include:

Some of our forms and publications are preprinted and can be ordered directly from Document Sales.

 

Certified Family Child Care Application Forms
Number Date Translation Type Title
 DCF-F-DWSW48-E 05/15  English Word  Certification Application - Family/In-Home Child Care Programs
DCF-F-DWSW48-E 05/15  English PDF  Certification Application - Family/In-Home Child Care Programs
DCF-F-DWSW48-S 05/15 Spanish PDF Solicitud de Certificación para Brindar Cuidado Infantil Diurno Residencial y Familiar
 DCF-F-DWSW48-H 05/15 Hmong PDF Ntawv Thov Zov Menyuam Hauv Tsev rau Tsev Neeg
DOA-IRS-W9 12/14 English Word W-9 Taxpayer Identification Number (TIN) Verification
Instructions to complete the W-9 Form
DCF-F-2978 06/16 English Word Background Information Disclosure (BID) Form
DCF-F-2978-S 06/16 Spanish Word Divulgacion de Informacion de Antecedentes
DCF-F-2978-H 06/16 Hmong Word Daim Ntawv Qhia Tawm Kom Paub Keeb Kwm Yav Dhau Los
DCF-F-DWSW13260-E 05/16 English PDF Landlord Permission to Operate a Certified Child Care Business
(Needed if applicant is renting the home where the care will be given.)
DCF-F-DWSW13259-E 07/13 English Word

Regulatory Agency Approval/Acknowledgement to Operate Child Care Business

(Applicant holds another license/certificate to care for children or adults. Example: foster parent or child care license.)

DCF-F-DWSW13259-E 07/13 English PDF

Regulatory Agency Approval/Acknowledgement to Operate Child Care Business

(Applicant holds another license/certificate to care for children or adults. Example: foster parent or child care license.)

DCF-F-DWSW49-E 09/17 English PDF Standards and Checklist – Family / In-Home Child Care Certification
DCF-F-DWSW49-S 09/17 Spanish PDF Normas y Lista de Verificación – Certificación de Cuidado Infantil Familiar / en la Casa
DCF-F-DWSW49-H 09/17 Hmong PDF Cov Quag thiab Daim Ntawv Txheeb – Tsev Neeg / Ntawv Pov Thawj Zov Me Nyuam Hauv Tsev
DCF-F-5109 09/16 English PDF YoungStar Contract - Family Provider
DCF-F-5109-S 09/16 Spanish PDF Contrato de YoungStar – Proveedor familiar
DCF-F-5109-H 09/16 Hmong PDF YoungStar Daim Ntawv Cog Lus – Zov Me Nyuam Hauv Tsev
DCF-F-2587 04/16 English PDF

Wisconsin Shares Participation Contract
Required for In-home (providers caring for children in the child's home) applicants who will be caring for Wisconsin Shares funded children.

DCF-F-2587-S 04/16 Spanish PDF Contrato de participación en Wisconsin Shares
(Wisconsin Shares Participation Contract)
Obligatorio para solicitantes que cuidan a niños en la casa (proveedores que cuidan a niños en la casa del niño) que cuidarán a niños financiados por Wisconsin Shares.
DCF-F-2587-H 04/16 Hmong PDF Wisconsin Shares Qhov Kev Koom Daim Ntawv Cog Lus
(Wisconsin Shares Participation Contract)
Cov neeg ua ntawv thov kev pab zov me nyuam hauv tsev (cov uas zov cov me nyuam hauv tus me nyuam tsev) uas yuav zov cov me nyuam tau nyiaj pab them los ntawm Wisconsin Shares yuav tsum muaj daim ntawv no.
ACT 20 Fingerprint Info NA English PDF Fingerprint Background Check Requirement

 

 

Certified Operator Forms and Publications
Number Date Translation Type Title
DCF-P-2436 07/17 English PDF  Your Guide to Regulated Child Care - Summary of the Child Care Rules
DCF-P-2436-S 07/17 Spanish PDF Su Guia Para el Cuidado Infantil Regulado - Su resumen sobre las normas del cuidado infantil
DCF-P-2436-H 07/17 Hmong PDF Koj Cov Lus Qhia Rau Kev Zov Me Nyuam Muaj Txoj Cai Tswj- Koj cov ntsiab lus ntawm kev zov me nyuam cov cai
DCF-F-CFS0059 08/10 English Word Authorization to Administer Medication - Child Care Centers
DCF-F-CFS0059 08/10 English PDF Authorization to Administer Medication - Child Care Centers
DCF-F-CFS0059-S 08/10 Spanish PDF Autorizacion para Administrar Medicamentos – Centros de Cuidado de Ninos
DCF-F-CFS0059-H 08/10 Hmong PDF Ntawv Tso Cai Muab Tshuaj Rau Me Nyuam Noj – Chaw Zov Me Nyuam
DCF-F-CFS0059-R 08/10 Russian PDF РАЗРЕШЕНИЕ НА ПРИМЕНЕНИЕ ЛЕКАРСТВЕННОГО СРЕДСТВА — ДЕТСКИЕ САДЫ
DCF-F-CFS0060 07/13 English PDF Child Health Report - Child Care Centers
DCF-F-CFS0060-S 07/13 Spanish PDF Informe Médico del Niño – Guarderias
DCF-F-CFS0060-H 07/13 Hmong PDF Qhia Paub Txog Me Nyuam Kev Noj Qab Haus Huv – Cov Chaw Zov Me Nyuam
DCF-F-62-E 05/16 English Word Daily Attendance Record - Certified Child Care
DCF-F-62-E 05/16 English PDF Daily Attendance Record - Certified Child Care
DCF-F-62-S 05/16 Spanish PDF Registro diario de asistencia – Programa certificado de cuidado infantil
DCF-F-62-H 05/16 Hmong PDF Daim Ntawv Teev Npe Zov Txhua Hnub – Chaw Muaj Ntawv Tso Cai Zov Me Nyuam
F-44192 09/08 English PDF Day Care Immunization Record (required for all children in care)
F-44192S 09/08 Spanish PDF Registro de Inmunizaciones para Guardería Infantil
DCF-F-DWSW13251-E 01/15 English Word Child Enrollment and Health History - Certified Child Care
DCF-F-DWSW13251-E 01/15 English PDF Child Enrollment and Health History - Certified Child Care
DCF-F-DWSW13251-S 01/15 Spanish PDF Inscripción de Niños e Historial de Salud – Guardería Certificada
DCF-F-DWSW13251-H 01/15 Hmong PDF Kev Tso Npe thiab Kev Noj Qab Haus Huv Yav Dhau Los ntawm Menyuam Yaus – Ntawv Pov Thawj Kev Tu Menyuam Yaus
DCF-F-CFS0055 12/16 English Word Incident Report - Regulated Child Care Centers
DCF-F-CFS0055 12/16 English PDF Incident Report - Regulated Child Care Centers
DCF-F-CFS0061 01/09 English PDF Intake for Child Under 2 Years - Child Care Centers
DCF-F-CFS0061-S 01/09 Spanish PDF Admision Para Ninos menores de 2 Anos - Guarderias
DCF-F-CFS0061-H 01/09 Hmong PDF TXAIS TU COV MENYUAM YAUS HNUB QIS DUA 2 XYOOS - TSEV TU MENYUAM YAUS
DCF-F-CFS0061-R 01/09 Russian PDF ПРИЕМ ДЕТЕЙ ДО 2 ЛЕТ – ЦЕНТРЫ ПО УХОДУ ЗА ДЕТЬМИ
DCF-F-DWSW50 07/16 English PDF Parent Checklist - Certified Family Child Care Providers
DCF-F-CFS53A 05/16 English Word

Staff Continuing Education Record

DCF-F-CFS53A 05/16 English PDF Staff Continuing Education Record
Written Policies 08/12 English Word Written Policies: Worded for licensed providers, but the Word-fillable version can be modified to apply to certified providers.
Written Policies 08/12 English PDF Written Policies: Worded for licensed providers but the Word-fillable version can be modified to apply to certified providers.
DCF-F-242-E 05/12 English Word Child Record Checklist Certified Child Care
DCF-F-242-E 05/12 English PDF Child Record Checklist Certified Child Care
DCF-F-DES12200-E 12/13 English Word Certification Application - School-Age Care Centers
DCF-F-DES12200-E 12/13 English PDF Certification Application - School-Age Care Centers
DCF-F-DES12203 08/16 English PDF Standards and Checklist
DCF-F-CFS2344 12/12 English PDF Building Inspection Report
DCF-F-5109 09/16 English PDF YoungStar Contract - School-Age Programs
DFC-F-2978 06/16 English Word Background Information Disclosure (BID) Form
0-NA 08/12 English Word Policy Sample - Family Child Care Centers
0-NA 08/12 English PDF Policy Sample - Family Child Care Centers
DCF-P-5202 09/17 English PDF DCF Approved Agencies Offering Non-Credit Courses
DCF-P-5206 07/17 English PDF Barred Offenses - Regulated Child Care
DCF-F-0053a 05/16 English PDF Staff Continuing Education Record - Regulated Child Care Centers
DCF-F-2114 04/13 English PDF Continuing Education Record - Independent Reading/Video Viewing