Commonly used provider forms

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Below are links to some commonly-used forms. Feel free to copy these forms as needed.
If you have a question about a form in particular, please contact your licensing representative.

Forms for Children in Licensed Care:

• CFS 428 Application/Record of Child Information
• CFS 593 Consents to Day Care Providers
• CFS 600 Certificate of Child Health Exam
• CFS 1050-51 Summary of Licensing Standards for Day Care Homes
• CFS 1050-52 Summary of Licensing Standards for Day Care Centers
• CFS 1050-53 Summary of Licensing Standards for Group Day Care Homes

Forms for Licensees and their Employees:

• CANTS 22 Acknowledgment of Mandated Reporter Status
• CFS 508 Report of Persons Employed in a Childcare Facility
• CFS 508-01 Info on a Person Employed in a Childcare Facility
• CFS 560 Child Support Certificate
• CFS 583-A Certificate of Inspection for Unsafe Children’s Products (FACILITIES)
• CFS 583-B Certificate of Inspection for Unsafe Children’s Products (HOME)
• CFS 585-2 Certification of Radon Test
• CFS 597 Application for child care facility license
• CFS 600 Certificate of Child Health Exam
• CFS 602 Medical Report on an Adult in a Childcare Facility
• CFS 671 Childcare Facility Driver Application
• CFS 718-B-DC Authorization for Background Checks for Day Care

Other Useful Forms

• CFS 689 Authorization for Background Checks for Programs NOT Licensed by DCFS
• CFS 2026 Home Safety Checklist for Parents