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Licensed and Group Day Care (LDCH/GDCH) Forms
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*Indicates forms to be submitted to KDHE
Guidance for New Child Care Providers | Instructions for Completing CCL 201 07/2010 *CCL 201 Application 07/2010 en EspañolCL 201 *CCL 002 Request for KBI/SRS Registry Check 08/2011 en EspañolCL 002 *Fire/Life Safety Agreement (located at www.ksfm.ks.gov)
Portfolio Supplemental Forms in the LDCH/GDCH application packet
Supplemental Forms for the LDCH/GDCH CCL 005 Yearly Mechanical Safety Check 08/2011 en EspañolCL 005 CCL 009 Health Assessment, 16 & Older 08/2011 en EspañolCL 009 CCL 010 Authorization for Emergency Medical Care 08/2011 en EspañolCL 010 CCL 026 Short-Term Medication Authorization 02/2010 en EspañolCL 026 CCL 027 Long-Term Medication Authorization 02/2010 en EspañolCL 027 CCL 028 Notification of Injury, Illness, Critical Incident 08/2011 CCL 029 & 029a Child Medical Record, Immunization History, & Health Assessment 08/2011 CCL 034 Parental Permission, Off-Premise Trips 08/2011 en EspañolCL 034 CCL 035 Parental Permission, Off-Premise, Group Trips 08/2011 en EspañolCL 035 CCL 204 Provider’s Self-Evaluation Checklist 09/2003 CCL 206 Report of Directed Readings 08/2011 CCL 207 Record of Observations 08/2011
Additional forms not in the application packet CCL 031 Request for Exception 09/2003 CCL 039 Request for Family Foster Home Exception | CCL 032 Request for Amendment 08/2010 en EspañolCL 032 CCL 205 Schedule of Enrollment 08/2011
Informational Child Care Initial & Annual Surveys 06/2010 Child Care Complaint Survey Information 11/2010 Provider Guidance for Family Foster Home Exceptions | CCL 006 Reporting Suspected Abuse/Neglect 02/2010 en EspañolCL 006 CCL 008 Licensing of Child Care 08/2011 CCL 011 Recommended Health Supervision 12/2008 CCL 012 Behavior and Guidance 08/2011 en EspañolCL 012 CCL 025 Diapering of Children in Child Care 08/2011 CCL 033 Comparing Licensed Day Care Homes 02/2010 CCL 036 Selecting Child Care: Guide for Parents 03/2010 CCL 037 Guidelines for Exclusion 08/2011 en EspañolCL 037 CCL 208 Guidelines for Training: LDCH/GDCH 02/2010