Learn about the Strong Start Campaign.
Providers Forms
Below are important forms and information for Child Development Centers and Child Development Homes
Child Development Centers Forms
- Appointment & Separation Form [PDF]
- Application Checklist [PDF]
- CDC Application [PDF]
- Application Fees [PDF]
- Authorization for Child’s Emergency Medical Treatment [PDF]
- Clean Hands Certification [PDF]
- Corporation Information Form [PDF]
- DC Oral Health (Dental Provider Assessment Form) [PDF]
- DC Universal (Child) Health Certificate (April 2009) [PDF]
- Instructions for DC Universal (Child) Health Certificate (April 2009) [PDF]
- Emergency Contingency Plan [PDF]
- Employee Health Information [PDF]
- Fire Drill/Emergency Evacuation [PDF]
- Health Testing Requirements [PDF]
- Certificate of Occupancy [PDF]
- Medication Authorization [PDF]
- Registration Record for Child Receiving Care Away from Home [PDF]
- Required Aid Supplies Listing [PDF]
- Sample Daily Activity Schedule [PDF]
- Sample Program Policy Statement [PDF]
- Staff Health Certificate [PDF]
- Staff Qualifications Guide [PDF]
- Travel & Activity Authorization [PDF]
- Unusual Incident Report [PDF]
USDA Child & Adult Care Food Program Meal Guidelines
- Weekly Meal Planner [PDF]
- Weekly Infant Meal Planner [PDF]
Child Development Homes
- Provider/Application CDH Initial Licensure Checklist [PDF]
- CDH Application [PDF]
- Clean Hands Certification [PDF]
- Corporation Information Form [PDF]
- Application Fee Information [PDF]
- Emergency Contingency Plan [PDF]
- Unusual Incident Report [PDF]
- Employee Health Information Form [PDF]
- Staff Health Certificate [PDF]
- Registration Record for Child Receiving Care Away from Home [PDF]
- Authorization for Child’s Emergency Medical Treatment [PDF]
- Travel & Activity Authorization [PDF]
- Instructions for DC Universal (Child) Health Certificate (April 2009) [PDF]
- DC Universal (Child) Health Certificate (April 2009) [PDF]
- DC Oral Health (Dental Provider Assessment Form [PDF]
- Health Testing Requirements [PDF]
- Medication Authorization Form [PDF]
- Sample Program Policy Statement [PDF]
- Sample Daily Activity Schedule [PDF]
- Required Aid Supplies Listing [PDF]
- Fire Drill/Emergency Evacuation Forms [PDF]
USDA Child & Adult Care Food Program Meal Guidelines
- Weekly Meal Planner [PDF]
- Travel & Activity Authorization [PDF]
- Unusual Incident Report [PDF]
Contact Phone:
(202) 727-1839
Contact Fax:
(202) 741-5403
Contact TTY:
711
Contact Suite #:
4th Floor
Office Hours:
Monday to Friday 8:30 am to 5 pm





