Child Care Forms
Forms for child care assistance, grants, and compliance
Forms
By category
For parents and families
For parents and families
PASS I
- Child Care Assistance Program Rate Schedule (January 2023 - Current)
- Child Care Family Income and Contribution Schedule (January 2023 - Current)
- CC02 - Manual Authorization Request for PASS I
- CC03 - Parent Responsibility Agreement – PASS I
- PASS I Child Care Assistance Brochure
PASS II & III
- CC08 - Child Care Assistance Application
- CC24 - Health Status Report
- CC29 - Termination of Child Care Services
- CC36 - Employment Statement
- CC37 - Family Report of Change
- CC38 - Monthly Tip Ledger
- CC39 - Self-Employment Income / Deduction Worksheet
- CC46 - Child Care Assistance Program & Alaska Inclusive Child Care Program Request for Hearing
- PASS II & PASS III Child Care Assistance Brochure
Licensed child care facilities
Licensed child care facilities
- Alaska Employer Registration Form for Daycare Services form TREG
- Alaska New Hire Reporting Form 04-1050
- Child Care Licensing Brochure
- Child Care Program Office (CCPO) Brochure
- Example Children Attendance
- Introduction to the Provisional Child Care Licensing Process
- Sample Typical Daily Schedule of Activities
- CC25 - General Variance Application
- CC47 - Child Emergency Information (Please contact your licensing specialist)
- CC 52 - Application for Provisional Child Care License
- CC53 - Request for Nighttime Care Specialization
- CC54 - Request for Specialized Program Activity
- CC55 - Governing Body Information
- CC56 - Administrator Designation and Qualification Form
- CC57 - Child Care Facility-Administrator Reference
- CC60 - Child Care Facility Personnel Policies Checklist
- CC61 - Parents’ Guide to Licensed Care (Teddy Bear Letter)
- CC62 - First Aid and Disaster Kit Checklist
- CC63 - Emergency Evacuation Drill Report
- CC65 - Notification of a Facility Emergency
- CC67 - Get Out Alive! Evacuation Plan
- CC71 - Child Care Facility Staffing Plan
- CC72 - Permission to Operate a Child Care Business
- CC73 - Plan for Shared Use of a Child Care Facility
- CC74 - Plan for Alternate Outdoor Recreation Space
- CC75 - Request for Exemption
- CC77 - Child Care Facility Parent Policies Checklist
- CC89 - Plan of Care for a Child with Special Needs
- CC91 - Child Injury / Illness / Incident Report
- CC92 - Facility Schedule Reporting Form
- CC93 - Plant Safety Plan
- CC94 - Application for Biennial Child Care License
- CC95 - Report of Change
- CC100 - Parent List
- CC103 - Firearms and Ammunition Storage
- CC105 - Animal on Child Care Facility Premises
- CC258 - Associate Administrator Designation and Qualification
- CC259 - Associate Administrator Reference
License-exempt facilities
License-exempt facilities
- Alaska Employer Registration Form for Daycare Services form TREG
- Additional Information You Need to Know about In-home Care
- Approved Relative Child Care Provider Application Coversheet
- Approved Relative Child Care Provider Renewal Application Coversheet
- In-home Child Care Application Cover Sheet
- In-home Child Care Renewal Application Cover Sheet
- CC10 - Approved Child Care Provider Disaster Preparedness and Emergency Evacuation Plan
- CC11 - Approved Relative Child Care Provider Health and Safety Requirements
- CC18 - In-home Child Care Parent / Caregiver Agreement
- CC27 - Health and Safety Requirements for In-home Child Care
- CC40 - In-home Child Care Application
- CC42 - Approved Relative Child Care Provider Application
- CC47 - Child Emergency Information (Please contact your licensing specialist)
- CC81 - Approved Relative Health and Safety Inspection Checklist
- CC82 - Approved Relative Child Care Provider Renewal Application
- CC83 - Approved Relative Provider and In-home Caregiver Health and Safety Training Checklist
- CC86 - In-home Child Care Renewal Application
- CC103 - Firearms and Ammunition Storage
Child care assistance for providers
Child care assistance for providers
- Alaska Employer Registration Form for Daycare Services Form TREG
- Alaska New Hire Reporting Form 04-1050
- Child Care Assistance Program Rate Schedule (January 2023 - Current)
- Child Care Family Income and Contribution Schedule (January 2023 - Current)
- Certified / Accredited Provider Child Care Assistance Application Cover Sheet
- Example Children Attendance
- Licensed Provider Child Care Assistance Application Cover Sheet
- CC12 - Child Care Provider Rates and Responsibilities
- CC29 - Termination of Child Care Services
- CC41 - Licensed Provider Child Care Assistance Application
- CC43 - Child Care Provider Report of Change
- CC46 - Child Care Assistance Program & Alaska Inclusive Child Care Program Request for Hearing
- CC78 - Request for Payment
- CC79 - Amended Request for Payment
- CC84 - Certified / Accredited Provider Child Care Assistance
- CC85 - Children’s Daily Attendance
- CC89 - Plan of Care for a Child with Special Needs
Child care grants
Child care grants
- Child Care Grant Rate Schedule
- CC14 - Child Care Grant Report Form
- CC15 - CCG Reimbursement Request
- CC30 - Child Care Grant Application
- CC31 - Child Care Grant Reimbursement For Staff Salaries and Benefits or Substitute Care
- CC32 - Child Care Grant Request to Save Funds – Apply Past Funds
- CC33 - Child Care Grant Request For Good Cause Waiver Form
- CC35 - Child Care Grant Request For Administrative Review
- CC61 - Parents’ Guide to Licensed Care (Teddy Bear Letter)
- CC102 - Child Care Grant Request to Apply Funds to a Past Purchase