Forms and Documents

Applications

Please email dcyf.welcomeinbox@dcyf.wa.gov for application information. For Family Home moves, please call or email your licensor.

Outdoor Nature-Based (ONB) Forms

• ONB Initial Checklist
• Benefit/Risk Assessment and Mitigation Development for Outdoor Nature-Based (ONB) Child Care Programs
• ONB Program Notification to Emergency Response Agency (letter template)

Annual Compliance Forms

• For annual compliance forms, visit the WA Compass Provider Portal.
• For instructions, visit our Maintain Your License (Annual Compliance) webpage. 

Capacity Charts and Resources

• DCYF #15-874 License Change Planning Form
• Family Home Capacity Charts
• Center and School-Age Capacity Charts
• Outdoor Nature-Based Capacity Charts

Child Care Agreement

• DCYF #15-943 Child Care Agreement

Child Care Health Consultant Agreement

• DCYF #15-966 Child Care Health Consultant Agreement

Child Care Health Consultant On-Site Report

• DCYF #15-967 Child Care Health Consultant Onsite Report

Child Care Registration Form

• DCYF #15-879 Child Care Registration

Child Injury/Incident Report

• DCYF #15-941 Child Care Injury Incident Report

Chimney, Fireplace, Woodstove Use Statement

• DCYF #15-891 Chimney, Fireplace, Woodstove Use Statement

Daily Attendance Records

• DCYF #15-942 Daily Child Attendance Records

Family Home/Child Care Center - Feasibility Checklist

• DCYF #15-963 Family Home/Center Feasibility Checklist

Family Home Liability Insurance Notice

• DCYF #15-894 Family Home Child Care Liability Insurance Form

Family Home Floor Plan

• DCYF #10-057 Family Home Child Care Floor Plan Sketch Guide

Fire Safety

Fire Safety & Emergency Drills Form

• DCYF #15-892 Fire, Safety, Emergency Drills Record

Annual Fire Inspection - State Fire Marshal Form

• Family Home Fire Inspection Form
• Child Care Center/School-Age Program Fire Inspection Form

Immunizations

Certificate of Immunization Status Form

• Department of Health - Certificate of Immunization Status (CIS)

Certificate of Exemption

• Department of Health - School and Child Care Exemptions from Immunization Requirements

Care Plan Documents

• DCYF #15-970 Care Plan Documents - King County
  • Allergy Care Plan Packet
  • Asthma Care Plan Packet
  • Diabetes Care Plan Packet
  • Food Intolerance Care Plan Packet
  • Seizure Care Plan Packet
  • Individual Care Plan Packet

Initial Checklists for Applicants

• DCYF # 15-861 Initial Checklist for Child Care Center Applicant
• DCYF # 15-862 Initial Checklist for Family Home Child Care Applicant
• DCYF # 15-863 Initial Checklist for School-Age Program Applicant
• DCYF # 15-841 Initial Checklist for Outdoor Nature-Based Program Applicant 

Monitoring Checklists

Updated monitor visit checklists coming soon. If you are licensed, checklists are available on the Provider Portal.

Baseline Checklists

Baseline checklists coming soon.

Intent to Transfer License or Certification

• DCYF #15-853 Intent to Transfer Child Care License or Certification

Medication Log

• DCYF # 15-969 Child Care Medication Log

Medication Authorization Form

• DCYF #15-968 Child Care Medication Authorization

No Social Security Card Declaration Form

• DCYF #15-956 No Social Security Card Declaration

Notification and Staffing Plan for Absence

• DCYF #15-954 Notification of Staffing Plan Absence

Overnight Child Care Planning Form

• DCYF #15-895 Overnight Child Care Planning Form

Parental Notification Letters

Notice of Safe Sleep Non-Compliance

• DCYF #15-952 Notification to Parents and Guardian - Safe Sleep Non-Compliance

Probation Notification Letter

• DCYF #15-896 Probation Notification Letter

Parent-Guardian Permission Form

• DCYF #15-897 Child Care Parent Guardian Permissions         

Provider Portal Support (contact information)

• DCYF #LIC_0005 Provider Portal Support

Sanitizer or Disinfectant Approval Request

• DCYF #15-965 Sanitizer Disinfectant Approval Request

School-Age Program Feasibility Checklist

• DCYF #15-964 School-Age Feasibility Checklist

School-Based and Military Certification for Payment-Only Request Form

• DCYF #15-944 School Based and Military CFPO Form 

Tribal Certification

Please email Mindy Flett, Tribal Child Care Licensing Consultant, Office of Tribal Relations, at Mindy.Flett@dcyf.wa.gov.