Required Licensing Documents Needed to Issue a License 620-01-35-15

(Revised 11/24/23 ML #3775)

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The following items shall be reviewed and initialed by both the Licensing Specialist and the Licensing Supervisor A licensing visit will not be conducted and a license will not be issued until a provider submits all required licensing documentation:

1. Application to be Licensed, SFN 832

2. Fire Inspection Report

3. Documentation of pediatric CPR/AED Cards

4. Documentation of pediatric First Aid Cards

5. Cleared CBCU memorandums for all owners/operators, staff members, emergency designees, volunteers, and household members 18 years old and older that reside in the home where care is provided

6. An SFN 433 must be submitted annually for any individual residing in a home where care is provided who is age 12 through 17

7. Copy of Policies and Procedures upon initial licensure or change in policies/procedures

   1. Policies and Procedures shall be reviewed and initialed by both the Licensing Specialist and Licensing Supervisor.

8. Documentation to verify qualifications of staff members

9. Programming schedule upon initial licensure or change of hours

10. Floor Plan with square footage upon initial licensure of residence/facility, expansion of facility or other change in square footage

11. SFN 517, Child Care Evacuation Disaster Plan

12. Childcare Provider/Facility Staffing (SFN 1259) or equivalent

13. Documentation of department approved training to meet training requirements for each provider and staff member

14. Completed Licensing Checklist (SFN 1422, SFN 1423, SFN 1424, SFN 1425 or SFN 1257)

    1. Child file reviews

       1. A review of no less than 30 files must be conducted on site.

       2. If the abbreviated review reveals incomplete records, an additional 30 files must be reviewed.

       3. This process will continue, 30 files at a time, until no incomplete records are found or until all files have been reviewed.

       4. For facilities will less than 30 children enrolled, all files will be reviewed.

 

When applicable, the following additional items may be required:

1. Copy of pet immunizations

2. Copy of water test

3. Copy of all county forms

4. Food Inspection report

5. Liability Insurance

 

The provider should not be told that they are receiving a license until the required items are completed and the Licensing Supervisor approves the application.

 

The licensing study is an important key in determining if the provider should be given a license to operate a program as requested. The initial licensing study should be comprehensive; however, it is somewhat limited as some rules cannot be applied until after the program is operating.

 

Annual Review of a 2-Year License: The 2-year license annual review requirement is a scheduled review for the purpose of monitoring licensing requirements. Review 620-01-35-15 for list of requirements needed as part of an annual review of a 2-year license. NOTE: Some documents may be in the Provider Record from initial licensing however they shall be reviewed annually.

• 120 days prior to the one-year anniversary of a license: The Provider receives the Annual Review Letter from the Licensing System.

• 60 days prior to the one-year anniversary of a license: All required documentation must be received. If all required documentation has not been received, the Licensing System will send the provider the Past Due Annual Review Notice.

• 30 days prior to the one-year anniversary of a license: If all required documentation has not been received, the Licensing System will send the provider the 30-Day Alert.

• A licensing visit will not be conducted and a license will not be issued until a provider submits all required licensing documentation.