Form CCL400 "Orientation Checklist for Ldch/Gdch" - Kansas

What Is Form CCL400?

This is a legal form that was released by the Kansas Department of Health & Environment - a government authority operating within Kansas. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on June 1, 2017;
  • The latest edition provided by the Kansas Department of Health & Environment;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of Form CCL400 by clicking the link below or browse more documents and templates provided by the Kansas Department of Health & Environment.

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Download Form CCL400 "Orientation Checklist for Ldch/Gdch" - Kansas

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Kansas Department of Health and Environment
CCL 400
6/2017
Bureau of Family Health
1000 SW Jackson, Suite 200
Topeka, KS 66612-1274
Child Care Program:
(785) 296 -1270 Fax: (785) 559-4244
Website:
www.kdheks.gov/kidsnet
This LDCH/GDCH Review form is recommended but not required.
Facility Name: ____________________
License Number:__________________
Name of Person conducting the orientation: ___________________________
Date of Orientation: ___________
Name of Person receiving orientation: ________________________________
First Day of Employment: ___________
K.A.R. 28-4-114a(a) Orientation. (2) Each applicant, each applicant with a temporary permit, and each licensee
shall provide orientation to each individual who will be caring for children about the policies and practices of the
facility, including duties and responsibilities for the care and supervision of children. Each provider shall complete
the orientation before the provider is given sole responsibility for the care and supervision of children.
The following have been reviewed:
Licensing Regulations
Policies and practices for the LDCH/GDCH
Emergency Procedures
Behavior management and discipline practices
Schedule of daily activities
Supervision of children and includes any special needs or known allergies.
Health and safety practices, i.e. safe sleep, storage of hazardous materials, etc.
Confidentiality i.e. child records, taking and posting photos, etc.
_________________________________
___________
Signature of Person receiving orientation
Date
________________________________
___________
Signature of Person giving orientation
Date
Kansas Department of Health and Environment
CCL 400
6/2017
Bureau of Family Health
1000 SW Jackson, Suite 200
Topeka, KS 66612-1274
Child Care Program:
(785) 296 -1270 Fax: (785) 559-4244
Website:
www.kdheks.gov/kidsnet
This LDCH/GDCH Review form is recommended but not required.
Facility Name: ____________________
License Number:__________________
Name of Person conducting the orientation: ___________________________
Date of Orientation: ___________
Name of Person receiving orientation: ________________________________
First Day of Employment: ___________
K.A.R. 28-4-114a(a) Orientation. (2) Each applicant, each applicant with a temporary permit, and each licensee
shall provide orientation to each individual who will be caring for children about the policies and practices of the
facility, including duties and responsibilities for the care and supervision of children. Each provider shall complete
the orientation before the provider is given sole responsibility for the care and supervision of children.
The following have been reviewed:
Licensing Regulations
Policies and practices for the LDCH/GDCH
Emergency Procedures
Behavior management and discipline practices
Schedule of daily activities
Supervision of children and includes any special needs or known allergies.
Health and safety practices, i.e. safe sleep, storage of hazardous materials, etc.
Confidentiality i.e. child records, taking and posting photos, etc.
_________________________________
___________
Signature of Person receiving orientation
Date
________________________________
___________
Signature of Person giving orientation
Date