CCRH Forms

ES = Spanish version available.

Title
Form 2405, Affidavit for Risk Evaluation by Child Placing Agency
Form 2760, Controlling Person – Child Care RegulationES
Form 2819, CCR Residential Child Care Regulation Governing Body and Administrator
Form 2820, Educational Facility Request for Exemption from Child Care Regulation
Form 2885, Children’s Products Certification
Form 2906, Child Placing Agency Internal Investigation Report
Form 2910, CCR Application for a License or Certification to Operate a Child Day Care Facility
Form 2911, CCR Governing Body or Director Designation
Form 2937, Child Care Regulation Waiver/Variance Request
Form 2954, Child Care Licensing Family Violence Calls DisclosureES
Form 2960, CCR Application for a License to Operate a Residential Child Care Facility
Form 2961, Request to Accept Children from Law Enforcement
Form 2962, Verification of Liability Insurance
Form 2971, Child Care Regulation Request for Background CheckES
Form 2974, Request for Risk Evaluation Based on Past Criminal History or Central Registry FindingsES
Form 2982, Personal History Statement
Form 2985, Affidavit for Applicants for Employment with a Licensed Operation or Registered Child-Care HomeES
Form 2997, Results of Public Hearing
Form 3014, Administrator License – Renewal or Status Change
Form 3015, Application for a Child Care Administrator License or a Child-Placing Agency Administrator License
Form 3016, Administrator Licensing Reference for an Applicant
Form 3017, Child Care Regulation Request for Background Checks for an Administrator's License
Form 7277, Child Care Regulation Plan of Action