Edit, Download, and Sign the Family Home and Center Child Care License Application

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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.

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How to fill out the Family Home and Center Child Care License Application?

  1. 1

    Obtain the necessary personal, contact, and program information.

  2. 2

    Fill out the applicant and co-applicant information sections completely and accurately.

  3. 3

    Provide details about your child care program, including physical and mailing addresses.

  4. 4

    Complete the sections relevant to family home or child care center applicants.

  5. 5

    Sign the form where indicated and submit as instructed.

Who needs the Family Home and Center Child Care License Application?

  1. 1

    Individual providers who want to open a family home child care facility.

  2. 2

    Organizations looking to start a center-based child care program.

  3. 3

    Existing child care providers who need to renew their license.

  4. 4

    Government agencies applying for a child care license.

  5. 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.

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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.

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

This form collects information required for licensing family home and center child care programs.
fields
  • 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?

Use this form when applying for a new license or renewing an existing family home or center-based child care license.
fields
  • 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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