Child Care Self-declaration 620-01-30

(Revised 3/20/12 ML #3317)

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Self-declaration packets shall be made available at the county agency and should include the following:

 

  1. N.D.A.C. §75-03-07.1

 

  1. N.D.C.C ch. 50-11.1

 

  1. SFN 865 -- Application for Self-declaration

 

  1. Instructions and forms for fingerprint background check

 

  1. SFN 845 Child Information Sheet

 

  1. SFN 847 Parent’s Statement on the Health of a Child

 

  1. SFN 987 Self-declaration/Parent Health and Safety Self-declaration Application

 

  1. Cover Letter/Instructions from the authorized agent, including instructions for CPR and First Aid certification

 

  1. W-9 form and instructions

 

  1. SFN 508 for each emergency designee

 

  1. CCAP brochure

 

  1. CACFP Information

 

  1. CCR&R brochure

 

  1. Other appropriate brochures or information