Forms for certified child care centers

Emergency planning forms and documents

Use the Minnesota State Child Care Emergency Plan, DHS-7415 (PDF) and Keeping Kids Safe: Child Care Provider Emergency Planning Guide DHS-7414 (PDF) when preparing for your response to emergencies and disasters. Each certified center must have a unique emergency plan using the Child Care Emergency Plan, DHS-7955 (PDF) created by DHS. This frequently asked questions document (PDF) is also an important resource for child care centers.

Forms for certified centers

• Certified Child Care Center Drill Log Form (PDF)
• Certified Child Care Centers Background Study Worksheet: Is a background study required? DHS-7733B (PDF) (1/24)
• Checklist for Certified Child Care Centers (Excel) (12/24)
• Child Allergy Information Form (PDF)
• Child Care Center Medication Authorization, DHS-8373 (PDF) (1/24)
• Child Care Emergency Plan (PDF)
• Director Information Form for Certified Centers (PDF)
• Guidelines for Developing Policies and Procedures for Certified Centers, DHS-4719A (PDF) (10/25)
• Maltreatment of Minors Mandated Reporting Policy for Certified Centers, DHS-7634D (PDF) (7/25)
• Orientation Training Record for Certified Centers DHS-7953B (PDF) (1/25)
• Risk Reduction Plan, DHS-7954B (PDF) (9/25)
• Serious Injury and Death Report: (PDF) (Word DOC)
• Yearly In-service Training Record for Certified Centers (PDF) (12/22)