Forms


Child care licensing

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Required and sample forms can be found on this page.

Any personal data requested is collected in accordance with the DLBC privacy notice.

Affidavit of lawful presence in the United States
Client rights poster (English)
Client rights poster (Spanish)
Code of conduct agreement
License exempt notice (English)
License exempt notice (Spanish)
Using these forms is not mandatory. They are provided as examples and templates.
Admission agreement
Health Assessment
Annual training record
Approved menus
Behavior expectations (English)
Behavior expectations (Spanish)
Daily schedule
Diapering procedures
Director education credentials
Disaster drill log (semiannually)
Emergency numbers
Emergency plan (English)
Emergency plan (Spanish)
Emergency substitute statement
Fire drill log (monthly)
Fire drill log (quarterly/annually)
Incident report form
Infant/toddler record
Medication permission form
Monthly attendance record
Monthly attendance record (before and after school)
Sign in/out form (daily)
Sign in/out form (monthly)
Child care provider guide (English)
Child care provider guide (Spanish)

Follow us online

DHHS logo
Department of Health and Human Services
Multi-Agency State Office Building
195 North 1950 West
Salt Lake City, Utah
84116
 
Phone: (801) 538-4242
Email: [email protected]
 
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Resources

211Utah - United Way
Safe UT
Utah Domestic Violence Coalition
988 Suicide and Crisis Lifeline

Hotlines

Abuse/Neglect of Seniors and Adults with Disabilities
1-800-371-7897

Child Abuse/Neglect
1-855-323-DCFS(3237)

Crisis Line & Mobile Outreach Team
1-801-587-3000

National Suicide Prevention Lifeline
1-800-273-TALK(8255)

Sexual Violence Crisis Line
1-888-421-1100

Utah Domestic Violence
1-800-897-LINK(5465)

Child care menu

  • Home
  • Rules and license types
  • Apply for a license
  • Background checks
  • Training
  • Forms
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