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        LICENSING BRANCH
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Divisions
Divisions > Division of Early Childhood Development > Licensing
Forms

Licensing Forms


 

The forms listed below are in .pdf format. You will need the Adobe Acrobat Reader to view them. If you do not already have the Reader, click the image.

get acrobat reader

After the title/description of each form, the following indicators are used to show what type of child care facility the form is used for:
  • (HOME) - family child care homes
  • (CTR/LOC) - child care centers and letter of compliance facilities
  • (CTR) - child care centers only
  • (LOC) - letter of compliance facilities only
  • (ALL) - centers, homes, and letter of compliance facilities

    Click on the highlighted form number below. You may then print the form, fill it out, and mail to the appropriate OCC Regional Licensing Office via the U.S Postal Service. If you have any questions about the use of a form, please contact the Regional Licensing Office in your area.

    At this time, we cannot accept completed forms that are filed electronically or e-mailed. We apologize for any inconvenience this may cause.


    Form Number Title/Description
     
    100   new! Professional Development Plan (CTR)
    101A new! Professional Development Plan-1st Year(HOME)

    101B new! Professional Development Plan-Continuing (HOME)

    101C new!

    FDC Applicant – Initial Training Requirements (HOME)

    349 Application to Resume Service (HOME)
     
    356 Family Child Care Home Inspection Report (HOME)
     
    670 Announced Inspection Preparation Checklist - Child Care Centers and Letter of Compliance Facilities (CTR/LOC)
     
    671 Announced Inspection Preparation Checklist - Family Child Care Homes (HOME)
     
    672 Request for Continuing License or Letter of Compliance (CTR/LOC)
     
    673 Request for Continuing Registration (HOME)
     
    1200 Application - Initial (CTR/LOC)
     
    1201 Insurance Information (CTR/LOC)
     
    1203 Personnel List & Staff Change Report (CTR/LOC)
     
    1204 Medical Report for Child Care (ALL)
     
    1205 Personnel Information (CTR)
     

    1206

    		 Staffing Pattern (CTR/LOC)

    1207           Personnel Qualification Evaluation (CTR)

    1209 Changes in Facilities (CTR/LOC)
     
    1210-A A Letter of Compliance Inspection Report (LOC)
     
    1213 Variance Request (ALL)
     
    1214 Emergency Form (ALL)
     
    1215 Health Inventory (ALL)
     
    1216 Medication Order (ALL)

    1218 Menu Plan (CTR/LOC)
     
    1229 Substitute Form (HOME)
     
    1230 Application - Initial (HOME)
     
    1255 Child Care Center Inspection Report (CTR)
     
    1255-A Child Care Center Supplemental Inspection Report (CTR)
     
    1260 Release of Information (ALL)

    1261 Emergency Escape Plan (HOME)
     
    1267 Provider Information & Plan of Operation (HOME)
     
    1268 Environmental Health Survey (ALL)
     
    1270 Notice of Intent to Operate (CTR/LOC)
     
    1275 Additional Adult Application (HOME)
     
    1281 Request for Hearing (ALL)
     
    1285 Health History - Drop -in (CTR)
     
    1295 Self - Assessment Guide (HOME)
     
     
     
     
     
     
     
     
    		•
    Contact Information
    Maryland State Department of Education
    200 West Baltimore Street
    Baltimore, MD 21201
     Licensing Branch
    Regional Licensing Offices
    Finding the Right Child Care
    Parent's Guide to Regulated Care
    Una Guía para Padres (en español)
    Opening a Child Care Center
    Opening a Family Child Care Home
    Provider Grant Program
    Partners Newsletter
    Circular Letters
    Forms
    Formularios de Licencia (en español)
    Family Day Care Manual
    Child Care Center Manual
    Resource Documents
    Enforcement Actions and Appeals
    Internet Links
    Regulations
     Office of Child Care
    Licensing Branch
    Child Care Subsidy Branch (Purchase of Care Program)
    Program Development Branch
    Credentialing Branch
    Grants Programs
    Child Care Resource Centers
    Guidelines - Healthy Child Development
    Early Childhood Curriculum Project
    Issues / Complaints
    CCATS - Child Care Automated Tracking System
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