Colorado Childcare
State Requirements

Are you currently employed outside of home? If yes, describe the job and your hours of employment:
Have you or, has any person living in the home used for child day care, ever been convicted of any crime in Connecticut or any state? 
What will be your customary child day care hours?
Identify an emergency back up caregiver, a responsible adult (at least 20 years of age) who is able to arrive at the facility within ten (10) minutes: 
If you are applying for the family day care home license, list all the adults and children who reside in the family day care home: 
Do you, or does any person living in the home used for child care, have any known medical or emotional illness or disorder that would pose a risk to children in care or would interfere with or jeopardize providing them with proper care?
Do you, or does any person living in the home used for child care, take any medication(s) that would affect your ability to provide for the proper care of children?
Have you ever had any children (including your own, day care, foster and adoptive children) removed from your care or the care of any other household member by the police or a child protection worker?
Have you, or any person living in the home being used for child care, ever been investigated/questioned by representatives of the Department ofChildren and Families (DCF) or any other child protection agency,concerning the care of children, including alleged child abuse or neglect inConnecticut or any other state?
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