Provider Corner
Provider Forms
Acknowledgment of Independently Rolling Over
- To be used for infants under 6 months of age, who independently roll over and would like to remain in an alternate sleep position if they roll
- Infants must still be placed to sleep on their backs
- Form required if a parent or guardian requests that their infant be swaddled for sleep
- To be completed by the infant's physician if requesting an alternate sleep position for infants other than on their back
Background Study Log
- Provider should keep this form to write the date the background studies were mailed to the licensor. It will be reviewed at relicensing visits.
- Monthly and annual documentation log to be used for all cribs in child care.
- To document provider's fire and storm drills.
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list of training requirements for the license holder and anyone working in the program
Family Child Care Admission and Arrangements
- Information sheet on family and child
- Gives provider authorization to obtain medical care for the child
- For provider to use to ensure all enrollment forms are obtained for each child
- To list dates of immunizations
- To be completed annually and whenever there is a change in insurance status
Parental permission slip for provider to use:
- Non-prescription drugs
- Sunscreen
- Suntan lotion
- Other
- Provider policies to be discussed with parent of enrolling family
- Where to report suspicions of abuse or neglect
- Summary of family and group family child care rules given to parents
- Permission slip to be signed by parent allowing child to travel in a car or participate in activities away from the provider's home
- To be able to use an inground swimming pool with parent’s permission
- To be able to use wading pool with parent's permission
- Provider sends this completed form to their licensor when a child is hurt in day care
- Form required to report a case of chicken pox to the Minnesota Department of Health
- Required to be completed and updated annually
- To diagram provider's home
- Booklet used during home visit to check compliance
- Required for adult caregivers working 30 days or more a year in a child care home
Request for Expedited Correction Order Reconsideration
- To be used when a correction order compliance would require a large amount of money or significant changes.
- For provider to use when asking to be over capacity
- WCHHS Family Child Care Variance Policy 2023
- To be completed with each application in order verify compliance with this law
Substitute Tracking Hours Form
- Form to document hours a substitute is used for your program
Is a Background Study Required?
- Guidance form to determine if background studies are required
- Complete at re-licensing time with all children in care for the previous 12 months
- Form to submit to DHS following a rule interpretation dispute during an annual visit
Other Helpful Resources
DevelopTool
Eager-to-Learn
- Online child care training
Resource Library Titles - Contact Licensor for check out procedures
SUID/AHT Videos - Providers may view the SUID/AHT videos on alternate years when training is completed.
- A great resource for all things related to babies and small children
Centers for Disease Control and Prevention
- A list of developmental milestones and a developmental checklist
Child Care Assistance Program (CCAP)
- Information on how to become registered to receive CCAP
- Includes information on starting your business, including grant information
Child Welfare Information Gateway
- The role of professional child care providers in preventing and responding to child abuse and neglect
Choosing Child Care Parent Toolkit
- A helpful resource for parents choosing child care which offers ideas for questions to ask and how to choose a quality child care setting
Consumer Product Safety Commission
- Check recalls on products including toys and cribs
DHS Licensed Family Child Care
- DHS site which includes notices for providers, legislative updates, background study information and forms.
- An informative website containing information on food safety, diet, and breast feeding
Hennepin County Infectious Disease Manual
Keeping Kids Safe: Your Home Child Care Emergency Plan
- Will help you be ready to respond to emergencies while you are caring for other people's children AND to keep your own family safe
- The local child care resource and referral site for the 4-county area, Wright, Stearns, Sherburne, and Benton counties
Minnesota's Statewide Child Care Emergency Plan
- Addresses the roles and responsibilities for coordination, communication, and support in the event of a disaster or emergency
Ombudsperson for Family Child Care Providers (OFCCP)
- Lisa Thompson was named ombuds by Governor Tim Walz and started the position in July 2022. As ombudsperson, her responsibility is to advocate on behalf of family child care providers regarding licensing, compliance issues, and other areas of concern. In the coming months, a new website will launch with information about the Ombudsperson for Family Child Care Providers (OFCCP). If you would like to reach Lisa, her email is ombuds.fccp@state.mn.us and her phone number is 612-322-2241. If you would like to talk with Lisa and need an interpreter, one will be provided.
Poisonous Plants and Family Child Care Guidance (June 2018)
- Provides activities, games, and folder book games for children
Use of Disinfectants in Child Care Home
- A list of approved disinfectants to be used in a child care home
- Provides a wealth of information including an interesting section that answers questions on brain development in young children and what providers can do to help with brain development
Wright County Child Care Newsletters