Bureau of Child Care Forms Available from DHSS Warehouse

Updated on 6/2/2008

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44 forms in this list.
Catalog Number Name Quantity Per Unit Program Restrictions
BCC-1 APPLICATION FOR LICENSE TO OPERATE A GROUP CHILD CARE HOME OR CHILD CARE CENTER EACH Bureau of Child Care LIMIT/1
BCC-10 EQUIPMENT LIST EACH Bureau of Child Care LIMIT/1
BCC-106 REPORT OF ACCIDENT, INJURY AND/OR EMERGENCY MEDICAL CARE EACH Bureau of Child Care LIMIT/1
BCC-11 MEDICATION AUTHORIZATION EACH Bureau of Child Care LIMIT/1
BCC-12 PARENT'S SPECIALIZED INSTRUCTIONS FOR INFANTS/TODDLERS EACH Bureau of Child Care LIMIT/1
BCC-14 FIRE/TORNADO DRILL RECORD EACH Bureau of Child Care LIMIT/1
BCC-15 DAILY SCHEDULE EACH Bureau of Child Care LIMIT/1
BCC-16 CHILD CARE FACILITY OVERLAP REQUEST EACH Bureau of Child Care LIMIT/1
BCC-17 APPLICATION FOR LICENSE REVISION EACH Bureau of Child Care LIMIT/1
BCC-18 PERMISSION FOR CHILD TO LEAVE FACILITY EACH Bureau of Child Care LIMIT/1
BCC-1-A INSTRUCTIONS TO APPLICANTS FOR AN INITIAL LICENSE FOR A GROUP CHILD CARE HOME OR CHILD CARE CENTER EACH Bureau of Child Care LIMIT/1
BCC-1-B REQUIREMENTS FOR RENEWAL OF GROUP CHILD CARE HOME OR CHILD CARE CENTER LICENSE EACH Bureau of Child Care LIMIT/1
BCC-2-1 APPLICATION FOR LICENSE TO OPERATE A CHILD CARE HOME EACH Bureau of Child Care LIMIT/1
BCC-2-2 APPLICATION FOR LICENSE TO OPERATE A CHILD CARE HOME (PAGE 2) EACH Bureau of Child Care LIMIT/1
BCC-25-1 VARIANCE REQUEST EACH Bureau of Child Care LIMIT/1
BCC-25-2 VARIANCE REQUEST/INTEROFFICE COMMUNICATION EACH Bureau of Child Care LIMIT/1
BCC-2-A INSTRUCTIONS TO INITIAL APPLICANTS FOR A FAMILY DAY CARE HOME LICENSE EACH Bureau of Child Care LIMIT/1
BCC-2-B REQUIREMENTS FOR RENEWAL OF CHILD CARE HOME LICENSE EACH Bureau of Child Care LIMIT/1
BCC-3-1 STAFF SHEET EACH Bureau of Child Care LIMIT/1
BCC-34-1 SANITATION INSPECTION REPORT, FAMILY CHILD CARE HOME EACH Bureau of Child Care LIMIT/25
BCC-34-2 SANITATION INSPECTION REPORT, FAMILY CHILD CARE HOME EACH Bureau of Child Care LIMIT/25
BCC-35-1 SANITATION INSPECTION REPORT (PG.1) EACH Bureau of Child Care LIMIT/25
BCC-35-2 SANITATION INSPECTION REPORT (PG.2) EACH Bureau of Child Care LIMIT/25
BCC-35-3 SANITATION INSPECTION REPORT (PG.3) EACH Bureau of Child Care LIMIT/25
BCC-38-1 BUREAU OF CHILD CARE / REIMBURSEMENT REQUEST FOR CHILD CARE SANITATION INSPECTIONS EACH Bureau of Child Care LIMIT/15
BCC-38-2 REIMBURSEMENT REQUEST FOR CHILD CARE SANITATION INSPECTIONS EACH Bureau of Child Care LIMIT/15
BCC-4 MEDICAL EXAMINATION REPORT FOR CHILD CARE PROVIDER/STAFF EACH Bureau of Child Care LIMIT/1
BCC-47 OBSERVATIONS/DISCUSSIONS EACH Bureau of Child Care LIMIT/1
BCC-5 CHILD IMMUNIZATION HISTORY EACH Bureau of Child Care LIMIT/1
BCC-55 CHILDREN'S ENROLLMENT/ATTENDANCE CHART EACH Bureau of Child Care LIMIT/1
BCC-56 ASSISTANT APPROVAL REQUEST EACH Bureau of Child Care LIMIT/1
BCC-57 RELATED CHILD IN CARE EACH Bureau of Child Care LIMIT/1
BCC-6A CHILD MEDICAL EXAMINATION REPORT EACH Bureau of Child Care LIMIT/1
BCC-6B PARENTS HEALTH STATEMENT FOR SCHOOL AGE CHILD EACH Bureau of Child Care LIMIT/1
BCC-7 CHILD ENROLLMENT EACH Bureau of Child Care LIMIT/1
BCC-73 FACILITY DIRECTOR APPROVAL REQUEST EACH Bureau of Child Care LIMIT/1
BCC-75-1 PROPOSED CHILD CARE FACILITY SITE OR PLAN REVIEW PAGE 1 OF 3 EACH Bureau of Child Care LIMIT/1
BCC-75-2 OBSERVATIONS AND / OR CORRECTIONS FOR LICENSURE PAGE 2 OF 3 EACH Bureau of Child Care LIMIT/1
BCC-75-3 OBSERVATIONS AND / OR CORRECTIONS FOR LICENSURE PAGE 3 OF 3 EACH Bureau of Child Care LIMIT/1
BCC-8 CHILD CARE PRACTICES & CONCEPTS EACH Bureau of Child Care LIMIT/1
BCC-9 SAMPLE WEEKLY MENU EACH Bureau of Child Care LIMIT/1
BCC-M-1 LICENSING RULES FOR GROUP CHILD CARE HOMES AND CHILD CARE CENTERS CASE Bureau of Child Care PROGRAM APPROVAL REQUIRED
BCC-M-2 LICENSING RULES FOR FAMILY CHILD CARE HOMES CASE Bureau of Child Care PROGRAM APPROVAL REQUIRED
BCC-M-3 DHSS (DEPARTMENT OF HEALTH & SENIOR SERVICES) RULES FOR LICENSE-EXEMPT CHILD CARE FACILITIES CASE Bureau of Child Care PROGRAM APPROVAL REQUIRED