Forms & Documents

As a result of recent legislation, effective July 1, 2021, child care licensing fees will be suspended until June 30, 2023.

Applications

You must attend orientation before submitting a licensing application.

Family Home or Child Care Center Application
School-Age Application

Capacity Increase/Change Planning Form

Child Care Agreement

Child Care Health Consultant Agreement

Child Care Health Consultant On-Site Report

Child Care Registration Form

Child Injury/Incident Report

WAC 110-300-0475 requires family home providers and child care center providers to use this DCYF form when reporting certain injuries and incidents to the department. School-age providers may use this form, but WAC 110-305 does not require the use of it.

Chimney, Fireplace, Woodstove Use Statement

Daily Attendance Records

Family Home/Child Care Center - Feasibility Checklist

Family Home Liability Insurance Notice

Fire Safety

Fire Safety & Emergency Drills Form

WAC 110-300-0470(4) requires family home providers and child care center providers to use this DCYF form. School-age providers may use this form, but WAC 110-305 does not require use of this specific form.

Annual Fire Inspection - State Fire Marshal Form

WAC 110-300-0170 requires a family home provider and a child care center provider to arrange for a fire safety inspection annually.  WAC 110-301-0170 requires a school-age provider to arrange a fire safety inspection annually. If a local government agency is not available to conduct a fire safety inspection, the provider must inspect for fire safety using the State Fire Marshal form.

Immunizations

Certificate of Immunization Status Form
Certificate of Exemption

Individual Care Plan & Food Allergy Forms

Initial Checklists for Applicants

Intent to Transfer License or Certification

Medication Log

Medication Authorization Form

Monitoring Checklists (Example)

No Social Security Card Declaration Form

Notification and Staffing Plan for Absence

Overnight Child Care Planning Form

Parental Notification Letters

Notice of Safe Sleep Non Compliance PDF
Probation Notification Letter

Parent-Guardian Permission Form

Provider Portal Support (contact info)

Sanitizer or Disinfectant Approval Request

School-Age Program - Feasibility Checklist

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

Tribal Certification Request Letter

Water Safety

Licensing Guides

Licensing Action Information
Licensing Complaint Inspections
Licensing Compliance Agreements
Summary Suspensions and Revocations - information for child care providers
Summary Suspensions and Revocations - information for families
Hearing Request Form