I don't know for sure, but I have never heard of another state needing a special/different license to change diapers.

A lot of places that don't change diapers, preschools etc, don't meet the licensing standards for diaper changing areas (ie where I live, the 3 year old classrooms don't have changing tables), so the facility may not meet the diaper changing area requirements.

I think what they mean regarding pull-ups, is that the CHILD can remove them, and throw them away and put on a new one - then they can permit that. At least that's the way it works commonly here.

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