Colorado Childcare
State Requirements

Dear Family Day Care Applicant: Thank you for your interest in Family Day Care Home licensing. Please follow the instructions below to apply for the license.
1. Submit an Application Packet Complete each form listed below in blue or black ink and answer all the questions completely. We will begin processing your application as soon as we receive the Application Fee and the Application Form. You may send the rest of the forms as soon as you they are completed. Since the fingerprint responses can take at least 90 days, it is beneficial to submit them as early as possible.
• Application Be sure to answer all of the questions completely.
• $80 Application Fee Make your check payable to “Treasurer State of Connecticut”. This fee is not refundable.
• “Proof of Workers Compensation Insurance” This form is required even if you will not be employing any individuals.
• “Adult Medical Statement for Child Day Care” for all household members 18 years of age or older. Physical examination and TB test must have been within the past year.
• “CT Early Childhood Health Assessment Record” for all household members under 18 years of age. Physical examination must have been within the past year and immunizations must be up to date.
• First Aid Certification: Copy of both sides of a current certificate for an approved First Aid course. Be sure your course is on the enclosed “Approved First Aid Courses” list. If you have a well, you must also submit a well water test by a state certified laboratory completed within the past year.
• Fingerprints Submit two fingerprint cards for each household member 16 years of age or older.
* Fingerprint Fee Enclose a $19.25 check payable to “Treasurer, State of Connecticut” for each  person’s fingerprints. This fee is not refundable.
• DCF “Authorization for Release of Information” one for each household member 16
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