Family Child Care Licensor Library
This Licensor Library contains forms and documents commonly used in family child care licensing. Forms are also available on the Family Systems webpage.
Quick links
Family Child Care Licensing triage: 651-539-8300
DCYF.FCClicensing@state.mn.us
DCYF Family Child Care Licensing
Licensing Information Lookup (LIL)
Electronic Licensing Management System (ELMS)
NETStudy2
Licensor Link newsletter
February 2026 | Previous issues
Provider Link newsletter
February 2026 | Previous issues
DCYF Early Childhood Connector
DCYF Early Childhood Connector – Newsletter and quarterly Connector Calls
Minnesota Rules and Statutes – Family Child Care
Minnesota Statutes, Chapter 142B (Children, Youth, and Families)
Minnesota Statutes, Chapter 245C (Human Services Background Studies Act)
Minnesota Rules, parts 9502.0300 to 9502.0445 (Rule 2)
County agency delegated authority: Minnesota Rules, Chapter 9543 (Licensure of Programs)
Licensing forms
Required for each child
Family Child Care Admission and Arrangement Form (PDF) (9-18)
Family Child Care Enrollment Form (PDF) (7-19)
Liability Insurance Notice to Parents or Guardians (PDF) (8-18)
Allergy Information Form (PDF) (7-17)
Immunization Records – Resources from the Minnesota Department of Health
Permission to Administer Medication (PDF) (7-18)
Maltreatment of Minors Mandated Reporting – Family Child Care (PDF) (6-25)
Rule and Statute Summary for Parents (PDF) (9-25)
Licensing actions
3324 – License Recommendation
Licensing Actions (PDF) (2-20)
Recommendation for Licensing Action (PDF) (6-24)
Appropriate Action to Take at the Expiration of a License (PDF) (9-25)
License Extension Request/Closure Pending Investigation (PDF) (1-19)
Pending Reopening instructions for county agency licensors (PDF)
Request for Temporary Provisional License (PDF) (7-22)
Guidance for closing an inactive license (PDF)
Sample letter – Closing an inactive license (DOCX) (11-24)
Family Child Care Fix-It Ticket Form (PDF) (2-18)
Variance request (10-23)
Licensing Intake Complaint Form (PDF) (11-22)
Complaint Log (11-22)
Licensor resources and information
Licensing inspection checklist - ELICI (XLS) (9-25)
ELICI User Guide
Develop tool
Family Child Care Licensor Access to Develop
Age Group Definitions – Family Child Care (PDF) (6-18)
Exclusions from Licensure – Family Child Care (6-18)
DCYF Commissioner Access Letter (PDF) (6-25)
Data Privacy Guidelines (PDF) (9-22)
Application forms
Family Child Care License Application (PDF) (7-22)
Preliminary Information Form (PIF)
Withdrawal of License Application (PDF) (3-24)
Application Tracking Log (PDF) (11-22)
Background studies
Child care provider background studies – Information and frequently asked questions (Minnesota Department of Human Services)
Family Child Care Background Study Worksheet: Is a background study required? (PDF) (9-20)
General Request for Reconsideration of a Disqualification (PDF) (1-24)
Variance Expiration Extension Request (PDF) (1-19)
Special Family Child Care
Special Family Child Care Program Plan (7-22)
Special Family Child Care Primary Provider of Care designation (PDF) (8-22)
Unlicensed care
Prohibition Letters (PDF) (6-12)
Prohibition Flowchart page 1 (PDF) (3-09)
Prohibition Flowchart page 2 (PDF) (3-09)
Unlicensed Family Child Care Letter – Sample (2-19) (DOCX)
Fire Marshal forms and information
Property Owner Permission for Fire Marshal Inspection (PDF) (1-26)
Request for Fire Inspection or Reinspection (PDF) (6-23)
State Fire Marshal – Child Care/Foster Care Inspections (Minnesota Department of Public Safety)
Minnesota Interagency Agreement Between the Departments of Public Safety and Human Services (PDF) (7-23)
Chemical use
Chemical Use Problems– Guidelines & Process (PDF) (8-19)
Chemical Use Problems – Variance Request (PDF) (3-23)
Risk of Harm Assessment and Recommendation (DOCX) (8-19)
Infant safe sleep
Helmet Approval for Sleeping Infant (PDF) (1-24)
Cradleboard Variance Request Form (PDF) (1-24)
Parent Cradleboard Request and Monthly Cradleboard Check Form (PDF) (1-24)
Directive for Alternative Infant Sleep Position (PDF) (1-24)
Swaddling Consent for an Infant (PDF) (1-24)
Optional Form for Parent Statement: Infant Less Than Six Months (PDF) (1-24)
Monthly Crib Safety Inspection Form (PDF) (6-14)
Safety and emergency planning
Child Care Emergency Plan (PDF) (4-24)
Emergency Escape Plan (PDF) (10-22)
Wading Pool Best Practices (PDF) (3-18)
Wading Pools Risks (PDF) (6-18)
Swimming Pool Risks (PDF) (6-18)
Wading Pool Permission Form (PDF) (6-18)
Swimming Pool Permission Form (PDF) (6-18)
Immediate Risk of Harm Determination Worksheet (PDF) (1-07)
Quarterly Serious Injury Reporting Form (PDF) (1-18)
Sample recommendation letters
Recommendation for Denial of a License (PDF) (3-16)
Sample Recommendation for a Temporary Immediate Suspension of a Family Child Care License (DOC) (2-19)
Sample Recommendation for a Conditional of a Family Child Care License (DOC) (2-19)
Recommendation for a Revocation for FCC License (PDF) (3-16)
Sample Recommendation for a Fine of a Family Child Care License (DOC) (2-19)
Sample Recommendation for Denial of Family Child Care License (DOC) (2-19)
Temporary Immediate Suspension Protocol (PDF) (3-08)
Certificate of Personal Service Sample (PDF) (4-23)
Licensing Action Notification Letter Samples for Family Child Care (DOCX) (5-19)
Alcohol and Drug Use Policy-Sample Family Child Care (PDF) (6-18)
Grievance Procedure Sample - Family Child Care (PDF) (6-18)
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