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Helpful Links

Tom Copeland
DHS Licensing webpage
Submit a Question to DHS
Electronic Licensing Inspection Checklist Information- paper
form of the electronic licensing checklist used by the licensor

CPSC Recall Search website
Family Child Care Provider email listSubscribe to
receive licensing information from DHS
CCIC free coaching services
CCIC coaching service referral process

Licensing Requirements Dispute form
Request for Expedited Correction Order Reconsideration 
Child Care Aware Region 4 Summer training calendar

Immunization records clarification by MN Dept. of Health

Relicensing Forms
Workers' Compensation Law Certificate of Compliance
DHS Licensing Requirements  
Enrollment Form
Safety, Pet Health & Staff Information
Fire & Storm Drill Log with time slot updated 
Training Record
   -To print your Develop training record, choose the 
"Knowledge & Competency Framework Record
under application reports on your "My Personal Profile" Summary tab

Information regarding Background Studies- studies are
not required for relicensing at this time. They are
required for anyone newly affiliated with your program

    Enrollment Forms
Activity Authorization Form  or
DHS Travel & Activity form NEW 9/2019 
Admissions & Arrangements Form updated 9/2019 
Allergy Information Form
Immunization Form- updated 4/2019   
Liability Insurance Notice
Mandated Reporter Policy  NEW 9/2019
Permission to Administer Medication  or
DHS Permission to Administer Medication form NEW 9/2019 
Rule 9502 Summary Form for Parents updated 9/2019

Infant Specific Forms

Physician Directive for Alternative Sleep Position 
Parental Consent for Swaddling
Infant Under 6 Months Rolling Over
- optional form
General Information
Age Group Ratios  
Chickenpox Reporting Information 
Custody Disputes & Unmarried Couples
Diapering & Handwashing Requirements
How to Avoid Spreading Germs in Your Daycare
Illness Exclusion Guidelines - For Providers
Keeping Kids Safe emergency planning guide
Poisonous Plants Guide
Record Keeping & Tax Tips
Reportable Disease Poster
Safe Water Temperatures
Supervision- What Does This Mean to Providers
Too Sick for Daycare - Handout for Parents
Training Requirements Spreadsheet
Weather Watch Information Sheet

Qualifying Fix-It Ticket Items list NEW 9/2019 

Safe Sleep Standards & Training Requirements Guide NEW 9/2019 

  General Forms
Accident Report Form- see Serious Injury Report form below
Bleach Alternative Checklist
Chickenpox Reporting Form
Crib Inspection Form  
Emergency Phone Numbers list NEW 9/2019 optional form
Emergency Preparedness Plan template
Addendum to Emergency Preparedness Plan NEW 9/2019
Floor & Escape Plan
Mandated Reporter Written Report Form
Physician Report Form
Serious Injury Report Form updated 9/2019
Substitute Tracking Hours Form NEW 9/2019 optional form
Variance Request Form

Pools & Wading Pools
Wading Pool Risks Sheet
Wading Pool Parent Permission
All the forms above are required when using wading pools
Wading Pool Best Practices

Difficult Conversations with Parents Resources
Illinois Early Learning Project
Parent-Caregiver Communication in Child Care Settings
Swimming Pool Risks Sheet
Swimming Pool Parent Permission
both forms are required when using a swimming pool

Available Resources
Various resources are available to checkout from Stevens County Human Services:  
  • Family Child Care: Record-Keeping Guide
  • Family Child Care: Legal and Insurance Guide
  • Family Child Care: Contracts and Policies
  • Well water test kits
  • Bite Bags
  • Various pamphlets