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How do I fill this out?
To fill out this form, you'll need to provide various details about yourself, your co-applicant (if any), and your child care program. Make sure to have all necessary information on hand before you begin. Follow the instructions carefully and ensure all sections are complete.

How to fill out the Family Home and Center Child Care License Application?
1
Obtain the necessary personal, contact, and program information.
2
Fill out the applicant and co-applicant information sections completely and accurately.
3
Provide details about your child care program, including physical and mailing addresses.
4
Complete the sections relevant to family home or child care center applicants.
5
Sign the form where indicated and submit as instructed.
Who needs the Family Home and Center Child Care License Application?
1
Individual providers who want to open a family home child care facility.
2
Organizations looking to start a center-based child care program.
3
Existing child care providers who need to renew their license.
4
Government agencies applying for a child care license.
5
Applicants who have been previously denied a license and want to reapply.
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What are the instructions for submitting this form?
Submit the completed form to the Washington State Department of Children, Youth, and Families (DCYF) via mail or fax. Mail: DCYF, Licensing Division, PO Box 40970, Olympia, WA 98504-0970. Fax: 360-725-4679. Ensure all required fields are filled and the form is signed before submission.
What are the important dates for this form in 2024 and 2025?
The revised form (DCYF 15-955) needs to be used starting January 2024.

What is the purpose of this form?
The purpose of this form is to provide a standardized application process for individuals and organizations seeking to obtain or renew a family home or center-based child care license. The form collects detailed information about the applicant, co-applicant, and the child care program to ensure compliance with Washington State regulations.

Tell me about this form and its components and fields line-by-line.

- 1. Type of License: Indicates whether the application is for a family home or center child care license.
- 2. Type of Application: Specifies whether the application is initial or other.
- 3. Applicant Information: Includes details about the applicant and co-applicant, such as names, addresses, and contact information.
- 4. Type of Organization: Specifies the type of organization applying for the license, such as government agency, Indian Tribe, or corporation.
- 5. Social Security Number: Includes the applicant's SSN or EIN if hiring staff.
- 6. Previous Licensing Information: Requests details about prior licensing history to provide child care.
- 7. Child Care Program Information: Details about the child care program, including name, address, and contact information.
- 8. Family Home Child Care Applicant Information: Section for family home applicants to list all persons living in the household and staff details.
- 9. Child Care Center Applicant Information: Section for child care center applicants to list staff and management details.
- 10. Non-Discrimination Agreement: Certifies that the applicant agrees not to engage in discriminatory practices.
- 11. Certification and Agreement: Acknowledges understanding of child care licensing requirements and permits DCYF to verify information.
- 12. Signature: Section for the applicant to sign and date the form.
What happens if I fail to submit this form?
Failure to submit this form may result in an inability to legally operate a child care facility. Applicants must comply with licensing requirements to avoid penalties.
- Legal Penalties: Operating without a license may result in fines and legal actions.
- Program Closure: Unlicensed facilities may be shut down by regulatory authorities.
- Loss of Funding: Failure to obtain licensing may result in loss of government funding and support.
How do I know when to use this form?

- 1. New Applicants: Individuals or organizations seeking to start a new child care program.
- 2. Renewal Applicants: Current license holders who need to renew their child care license.
- 3. Changes in Program: Applicants who have made significant changes to their program and need to update their license.
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