Forms for licensed family child care providers

In the coming months, licensing forms will be updated to incorporate the DCYF logo, updated contact information, and renumbered statutes as appropriate. Please download forms directly from this webpage to be sure you are using the current version.

Documentation required for every child in family child care
- Admission and Arrangements Family Child Care DHS-7776 (PDF)
- Liability Insurance Notice to Parents or Guardians Family Child Care DHS-7741 (PDF)
- Enrollment Form - Family Child Care (PDF)
- Immunization Records (resource list from the Minnesota Department of Health)
- Allergy Information Form Family Child Care DHS-7736 (PDF)
- Mandated Reporter Policy Family Child Care DHS-7634C (PDF)
When an infant is present
Only when a swimming pool or wading pool is in use
Documentation family child care license holders must maintain
The licensed program must also have documentation on the following:
- Attendance records if enrolled in CCAP
- Pet rabies documentation (if applicable)
- Completed background study
- The license holder, caregivers, substitutes and helpers must comply with training requirements and provide documentation of proof. If you are registered with Develop you can print your training record. If you have courses not listed on Develop you must provide proof of those to your licensor.
- If the license holder has employees, substitutes or helpers the license holder must maintain their training records and background studies.
License Holder Policies

License holders’ policies must have written information available for discussion with parents or the agency. They must contain the following information:
- The ages and numbers of children in care in the residence
- The hours and days of operation
- Meals and snacks to be served
- Labeling requirements for food brought from the child's home
- Sleeping and rest arrangements
- Nondiscrimination practices to comply with subpart 6
- Policies for the care of ill children, disease notification procedures, immunizations, and medicine permission policies
- Emergency, fire, and storm plans and the monthly fire drill log
- Seat belt and transportation plans and field trip and transportation permission requirements
- Fees
- Termination and notice procedures
- Plans for a helper and substitute for emergencies, vacations, or holidays
- The presence of pets in the residence
- A complete copy of Rule 2
- Insurance coverage
Reporting Obligations
You are to notify the authorized agent or Minnesota Department of Health of any suspected case of reportable disease specified in Rule 4605.7040.
Additional family child care license holder forms and information
Licensing (general)
Staffing
- Substitute Tracking Hours - Family Child Care (DHS-7965) (PDF)
- Variance Request Form - Extended Use of Substitutes (DHS-7964) (PDF)
Training
- Training Requirements for Family Child Care (DHS-7672) (3/25)
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.
- SUID & AHT Off-year Video Training Verification - Family Child Care (DHS-3803) (PDF)
Parent permissions
- Prescription and Non-Prescription Medication Administration Permission - Family Child Care (DHS-7746) (PDF)
- Travel and Activity Authorization (DHS-7773) (PDF)
Safety
- Serious Injury Reporting Form - Family Child Care (DHS-7774) (PDF)
- Wading Pool Best Practices Form - Family Child Care (DHS-7668B) (PDF)
- Poisonous Plants - Family Child Care (DHS-7745) (PDF)
- Fire inspections for child care facilities (Minnesota Department of Public Safety)
- Recalls and Product Safety Warnings (US Consumer Product Safety Commission)
Infant safe sleep