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HEALTH CARE PROGRAM FOR CHILD CARE CENTERS CHILD CARE CENTER HEALTH RECORDBUREAU OF CHILD CARE DIVISION OF FAMILY RESOURCESState Form 49969 (R2 / 1106) / BCC 0019Date of birth (month, day, year)Name
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To fill out child care center health forms, follow these steps: 1. Start by gathering all necessary information such as the child's personal details, medical history, and emergency contact information.
02
Review the form and ensure you understand each section and its requirements.
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Fill out each section accurately and truthfully, providing all required information.
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Pay attention to any specific instructions or additional documents that may be needed.
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Double-check the completed form for any errors or missing information.
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Sign and date the form, confirming that the information provided is true and accurate.
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Submit the completed form according to the specified submission method, whether in person, by mail, or electronically.
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Keep a copy of the filled-out form for your records.
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Remember, it is important to provide complete and accurate information to ensure the child's health and safety in the child care center.

Who needs child care center health?

01
Parents or legal guardians who require child care services for their children.
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Child care center health refers to the standards and regulations that govern the health and safety practices within a child care facility.
Child care centers and providers are required to file child care center health to ensure compliance with health and safety regulations.
Child care center health forms can typically be filled out online or on paper, depending on the requirements of the governing body.
The purpose of child care center health is to ensure the well-being and safety of children in child care settings.
Information such as staff training certifications, emergency procedures, health and safety policies, and vaccination records may need to be reported on child care center health forms.
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