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When a child is admitted in a child care program a Family Child Care Admission and Arrangement Form must be signed completed and kept in the child’s record. Within this form the license holder needs to complete the liability insurance notification, permission to obtain emergency medical care and authorization to transport a child. Prior to transporting children under the age of nine the caregiver must complete the required training.
License holders must notify parents in writing if they have or do not have liability insurance prior to admission. This notification may be included on the Admission and Arrangement form. If the license holder does not have liability insurance coverage they must provide annual notice to parents on this DHS form. If the license holder has coverage and the policy changes or lapses they must provide notice to parents on this DHS form; however, if there are no changes to the continuous coverage no further notices are required.
License holders must complete the following information for all children you have cared for over the last 12 months, whether they are still in care or not and whether they are full or part time. Evaluations will be sent to at least two of these parents.
Documentation of immunizations must be in a child’s record. An immunization printout from a medical facility is a medical record and will meet the documentation requirement. It does not need a signature.
The Minnesota Department of Health provides a resource list on immunization topics for child care providers.
When a child has an allergy, the parent must complete and sign the DHS approved Family Child Care Allergy Information Form. This must be completed before the child is admitted. The signed form must be in the child’s records.
As of Sept. 30, 2019 you must give this document to parents of children who enroll in your program. Parents can acknowledge receipt of this document by using the checkbox on the Admission and Arrangements form. You are not required to distribute this document to currently enrolled families, but you must make them available upon request.
When an infant is present
When an infant is present in a program, parents or a physician or in some situations an advanced practice registered nurse may need to complete the following forms if they apply. The signed and completed form must be in the child’s records. See Minnesota Statue 245A.1435.
Placing a swaddled infant down to sleep in a licensed setting is not recommended and is prohibited for any infant who has begun to roll over independently. However, with written consent of the parent and a one-piece sleeper equipped with an attached system that fasten securely only across the upper torso, with no constriction of the hips or legs a license holder may swaddle an infant. The DHS required form must be completed and signed in the child’s record.
When an infant is present in the program the caregiver must place the infant to sleep on its back to sleep. An infant who independently rolls onto its stomach after being placed to sleep on its back may be allowed to remain sleeping on its stomach if the infant is at least six months of age or the license holder has a signed statement from the parent indicating that the infant regularly rolls over at home. This documentation must be in a child’s record. This form may be used to fulfill this requirement.
When an infant is present the license holder must place the infant to sleep on its back unless the license holder has documentation from the infant's physician, advance practice registered nurse, or physician assistant directing an alternative sleeping position for the infant. This DHS required permission form must be completed and signed in the child’s record.
Only when a swimming pool or wading pool is in use the following forms would need to be completed
When a wading pool is used these forms are required for each child in care. The risk sheet will be given to parents and the permission form must be signed in the child’s records.
When a swimming pool is used these forms are required for each child in care. The risks sheet will be given to parents and the permission form must be signed in the child’s records.
The licensed program must maintain annual documentation on cribs against the United States Consumer Product Safety Commission Web to check equipment for recalls. Monthly safety inspections on every crib, portable crib, mesh-sided or fabric-sided play yard, pack and play, or playpen used by or accessible to any child in care must be conducted and documented. This form may be used to fulfill this requirement.
The licensed program must have a written fire escape plan and a log of monthly fire and storm drills. This form may be used to fulfill this requirement.
Applicants are required to complete the Certificate of Compliance of Minnesota Workers' Compensation Law form at application. This form must be updated if any of the information changes.
License holders must have a policy that prohibits license holders, employees, subcontractors, and volunteers, when directly responsible for persons served by the program, from abusing prescription medication or being in any manner under the influence. This policy can be contained within the license holders written policies to fulfill this requirement or this for may be used.
License holders must have a program grievance procedure for parents. This policy can be contained within the license holder's written policies to fulfill this requirement or this form may be used.
State law requires licensed family child care providers to use this form to create an emergency preparedness plan.
License holders must have emergency phone numbers of the parents and the child’s physician and dentist must be readily available. This form may be used to fulfill this requirement.
License holders do not need keep a copy in their records, however, a descriptive summary of parts 9502.0315 to 9502.0445 shall be distributed to parents.
Providers are required to maintain a log of monthly fire and storm drills. This form may be used to meet that requirement.
License holders’ policies must have written information available for discussion with parents or the agency. They must contain the following information:
Licensing (general)
Staffing
Training
Fact sheets on requirements for ongoing training, pre-licensing training, and helper training are being revised. Updated versions will be available soon; please refer to Training Requirements for Family Child Care (DHS-7672) in the interim.
Parent permissions
Safety
Infant safe sleep
