Commonly used forms
Child enrollment
| Child Enrollment Packet (English) (Spanish) | Packet of forms for enrolling a child that contains: * Child Enrollment Form * Written Permission Form * Early Childhood Health Assessment Record (birth to age 5) * Immunization Record * Child Care Incident Log * Emergency numbers |
| Child Enrollment Form (English) (Spanish) | Parents fill this out to provide information about their child |
| Written Permission Form | Allows parents to give permission for their child to participate in specific activities |
Health and medical
Health assessments
| Title | Description |
| Early Childhood Health Assessment Record (birth to age five) | Required health form for parents and a young child’s health care provider |
| Health Assessment Record (school age) | Required health form for parents and a school-age child’s health care provider |
Medication
| Title | Description |
| Authorization for Administration of Medication (English) (Spanish) | Required health form for parents and the child’s health care provider that allows staff to give medication |
| Authorization for Administration of Non-Prescription Topical Medications (English) (Spanish) | Authorizes staff to administer non-prescription topical medications to a child |
| Medication Administration Record Sample | Example of a chart you can use to keep track of medication |
| Medication Administration Policy Sample (English) (Spanish) | Sample policy you can adapt for how you provide medication to students |
| Petition for Special Medication Authorization | Checklist of steps and permissions needed for a child care facility to get authorization to give medication |
| Written Approval for Administration of Medication Training Certificate Sample | Example of a certificate you can adapt to show staff is trained to give medication in childcare settings |
Immunizations
| Title | Description |
| Immunization Requirements Schedule | Table showing required shots for different ages of children in child care programs |
| Medical Exemption for Required Immunizations | If a parent wants a child to be exempt from vaccinations, they and the child’s health care provider need to fill out this form |
First Aid and CPR
| Title | Description |
| First Aid & CPR Courses for Child Care (Spanish) UPDATE — LINKS ARE BROKEN ON CT.GOV | List of available courses |
Program licensing and operations
| Title | Description |
| Notify Licensing About Changes to Your Program (online form) | Required for any changes you make to your program that that differ from what’s stated in your license or application |
| Request technical assistance | Get help maintaining compliance and meeting licensing requirements |
| Report of Suspected Child Abuse or Neglect (DCF-136) | Form and instructions for mandated reporters to submit written reports |
Inspections and compliance
| Title | Description |
| Checklist for Maintaining Regulatory Compliance (English) (Spanish) | Checklist of essential requirements for family child care providers, including staff qualifications, safety standards, provider responsibilities, and medication administration guidelines |
| Corrective Action Plan and Resolving Disputed Violations (English) (Spanish) | If OEC finds a violation during an inspection, use this form to document how you plan to fix it |
| Guide to the Child Care and Youth Camp Investigation Process | Overview of how the complaint and investigation process works |
| Inspection Form Sample | An example of the form OEC will fill out when inspecting your program |
Records and documentation
| Title | Description |
| Child Care Incident Log (English) (Spanish) | Keep records of accidents, observations, injuries, illnesses, unusual behaviors |
| Child Records Checklist Sample (English) (Spanish) | An example of a form you can use to keep track of required child records and permissions |
| Emergency Phone Numbers (English) (Spanish) | Record of emergency contacts for each of your children to keep as a record |
| Household Member Records Checklist Sample (English) (Spanish) | Sample checklist you can adapt that outlines the required records for providers, staff, and household members |
| Individual Plan of Care Sample (English) (Spanish) | Sample form you can adapt for creating an individual plan of care for a child with special health needs or disabilities |
| Individual Plans of Care FAQs | Questions and answers about the purpose, requirements, and implementation of individual plans of care for children with special needs or disabilities |
Videos
Explore related pages
- Health and Safety: Find resources about ventilation, disease control, mandated reporting, and more.
- Helpful links: Quickly access key resources and essential information with our curated links for child care providers.
Last updated June 17, 2024