With the sharing of these resources, FCCAM is not rendering legal or tax advice. All material here is being shared to support your business practices and work with children. If you require more specific assistance, please consult a legal or tax preparation professional to represent you. ~ Please do not distribute any resources found here for profit. ~ You can modify and print any of the templates provided here for your own use. ~
This section contains the primary list of information Providers are required to maintain around children and their care. This information needs to be maintained in a format for anyone providing care to easily access. The listed items do not need to be individually broken out, but can be combined. In the section below requirements with the same color box are found on the sample document together.
D. (NEW) Child records. Child records must be updated annually and maintained in an organized fashion.
1. A record must be completed at the time of admission and maintained on the Premises for each Child in care (including relatives) and must include:
b. Name, street address, mailing address and telephone number of Parent(s) or Legal Guardian(s);
c. Places of employment of Parent(s) or Legal Guardian(s), if employed;
d. The current telephone number of Parent(s)’ or Legal Guardian(s)’ employers;
e. A method of contacting the Parent(s) or Legal Guardian(s) while the Child is in care;
f. The name, street address and telephone number of a person other than the Parent(s) or Legal Guardian(s) to contact in case the Parent(s) cannot be reached in an emergency;
g. (NEW) Copy of financial agreement with Parent(s) or Legal Guardian(s);
The Department included this requirement as an added protection for the Provider as well as to verify that a Provider is receiving compensation for services provided and thus required to be licensed. It is not to check rates charged.
h. Dates of enrollment and termination;
j. Names and telephone numbers of the Child’s physician and family dentist. If there is no identified family doctor or dentist, it must be noted on the Child record form;
k. Signed authorization to dispense Medication, if applicable;
While not required, best business practice encourages providers to complete a Medication Incident Report if there is any problem when dispensing medication.
l. Signed authorization to obtain emergency medical care;
n. A same-day record of all injuries, including serious injuries, Accidents, and Incidents or emergencies which reflects the time and date of verbal or written notification of Parent or Legal Guardian. The signature of the Parent or Legal Guardian must be obtained on the Incident report within 48 hours of the event;
Incident/Accident Report Folder contains a variety of templates for forms that cover minor incidents to death.
o. Written record of significant changes in appearance and/or hygiene upon arrival, or significant changes in behavior (such as: increased aggression, withdrawal, sexual acting out, and/or prolonged tantrums) and other health conditions, if known;
q. Any relevant documentation of medical necessity (for example, sleeping in a non-horizontal position), if applicable;
s. Signed permission for use or distribution of images or personal information of the Child on any publications, social media, or promotional materials;
t. Signed permission from the Child’s Parents before allowing the Child to participate in any high risk activity, including but not limited to swimming, horseback riding and using a trampoline. The permission must be updated at least annually, and indicate the type and location of activity;
*Providers understand the importance of children having opportunities to develop risk awareness through their play. The linked high risk activity template is structured for each program to list their specific equipment that can be considered high risk. It is recommended that you list it if there is any question. What we have shown in the template are just examples.
*If you do not have liability insurance, FCCAM encourages you to strongly consider securing that.
v. (NEW) Signed permission to transport the Child, if applicable.
Transportation permission forms: multiple template options that cover individual, longterm, vehicle, public transport and walking off premises.
2. Providers must place a written explanation in the Child’s record explaining why any required information is missing.
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