Form BCC-1A "Checklist for Initial Applicant for a Group Child Care Home or Child Care Center" - Missouri

What Is Form BCC-1A?

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

Form Details:

  • Released on August 1, 2019;
  • The latest edition provided by the Missouri Department of Health and Senior Services;
  • 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 BCC-1A by clicking the link below or browse more documents and templates provided by the Missouri Department of Health and Senior Services.

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Download Form BCC-1A "Checklist for Initial Applicant for a Group Child Care Home or Child Care Center" - Missouri

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Section for Child Care Regulation
CHECKLIST FOR INITIAL APPLICANT
FOR A GROUP CHILD CARE HOME OR CHILD CARE CENTER
The Section for Child Care Regulation (SCCR) begins a licensing inspection when the owner signs and submits a
completed application for licensure. If not privately owned, the board president, chairperson, or designee must
sign the application (see application instructions). The application is valid for six (6) months. The applicant must
read and become familiar with the licensing rules. All required documentation must be accepted and approved by
SCCR. The inspection will determine if the applicant complies with licensing requirements.
The applicant shall submit the following documents:
☐ A completed application.
☐ A diagram, sketch, or floor plan of the facility that shows the arrangement of indoor space; location of toileting,
diapering, and handwashing sinks; kitchen; office space; exits; and if applicable, infant/toddler space. The
space will be measured by the Child Care Facility Specialist and the applicant to determine official capacity.
☐ A diagram or sketch of the outdoor play area that shows fencing, placement of permanent equipment, and
access to the play area from the facility.
☐ Written policies pertaining to program goals, admission, care, and discharge of children.
☐ A written description of child care practices, including discipline and guidance policies.
☐ A written disaster and emergency plan. (A copy should be available in all areas used for child care and business
space.)
☐ Completed safe sleep policy (applicable if requesting licensure for children under 12 months of age).
☐ A schedule of planned daily activities for day and/or nighttime care for each age level included in the
application (infant/toddler, preschool, full day school-age and before and after school).
☐ A sample weekly menu.
☐ An itemized list of available materials and equipment to be used by the children.
☐ A staff sheet.
☐ Evidence of compliance, if applicable, with local building and zoning requirements.
☐ Written policies and procedures which clearly establish job responsibilities and lines of administrative
authority, as required, including a statement of the authority and duties delegated to the director employed to
carry out the program.
☐ Sample forms used in the daily operations of the facility, other than those supplied by the SCCR.
☐ If not privately owned, a copy of the Articles of Incorporation, Certificate of Incorporation, the Annual
Registration and Certificate of Good Standing from the Office of the Secretary of State or Operating Agreement
listing the members/ownership, if an LLC or other legal entity.
☐ Other information required by the department to make a determination regarding licensure of the facility.
Note: Please keep a copy of all submitted documents for your records.
1
(BCC-1A/Rev. 8/19)
Section for Child Care Regulation
CHECKLIST FOR INITIAL APPLICANT
FOR A GROUP CHILD CARE HOME OR CHILD CARE CENTER
The Section for Child Care Regulation (SCCR) begins a licensing inspection when the owner signs and submits a
completed application for licensure. If not privately owned, the board president, chairperson, or designee must
sign the application (see application instructions). The application is valid for six (6) months. The applicant must
read and become familiar with the licensing rules. All required documentation must be accepted and approved by
SCCR. The inspection will determine if the applicant complies with licensing requirements.
The applicant shall submit the following documents:
☐ A completed application.
☐ A diagram, sketch, or floor plan of the facility that shows the arrangement of indoor space; location of toileting,
diapering, and handwashing sinks; kitchen; office space; exits; and if applicable, infant/toddler space. The
space will be measured by the Child Care Facility Specialist and the applicant to determine official capacity.
☐ A diagram or sketch of the outdoor play area that shows fencing, placement of permanent equipment, and
access to the play area from the facility.
☐ Written policies pertaining to program goals, admission, care, and discharge of children.
☐ A written description of child care practices, including discipline and guidance policies.
☐ A written disaster and emergency plan. (A copy should be available in all areas used for child care and business
space.)
☐ Completed safe sleep policy (applicable if requesting licensure for children under 12 months of age).
☐ A schedule of planned daily activities for day and/or nighttime care for each age level included in the
application (infant/toddler, preschool, full day school-age and before and after school).
☐ A sample weekly menu.
☐ An itemized list of available materials and equipment to be used by the children.
☐ A staff sheet.
☐ Evidence of compliance, if applicable, with local building and zoning requirements.
☐ Written policies and procedures which clearly establish job responsibilities and lines of administrative
authority, as required, including a statement of the authority and duties delegated to the director employed to
carry out the program.
☐ Sample forms used in the daily operations of the facility, other than those supplied by the SCCR.
☐ If not privately owned, a copy of the Articles of Incorporation, Certificate of Incorporation, the Annual
Registration and Certificate of Good Standing from the Office of the Secretary of State or Operating Agreement
listing the members/ownership, if an LLC or other legal entity.
☐ Other information required by the department to make a determination regarding licensure of the facility.
Note: Please keep a copy of all submitted documents for your records.
1
(BCC-1A/Rev. 8/19)
The applicant shall have the following documents for director approval:
☐ Step 1. Center Director/Group Day Care Home Provider Certification Request, along with official verification of
education and experience, for evaluation to the Section for Child Care Regulation
☐ Step 2. Facility Director Approval Request to the Child Care Facility Specialist
The applicant must have verification of the below on file at the facility for the director / group home
provider and caregivers:
☐ Required completed medical examination reports and the Tuberculosis (TB) Risk Assessment form.
☐ Required comprehensive criminal background check results for all child care staff members and
volunteers.
☐ Evidence of completion of department-approved safe sleep training.
☐ Evidence of age-appropriate CPR/First Aid certification on file. Must have staff with proper
certification for every 20 children in the proposed capacity.
☐ Verification of current Class E, CDL, or Commercial Driver’s license for all adults who transport
children.
The applicant must have verifications of the below on file at the facility for children in care:
☐ A completed enrollment form, which includes identifying information, field trip permission, and
emergency care instructions.
☐ A report for each child in care (including school-age) that indicates the child has completed, is in the
process of completing, or is exempt from age-appropriate immunizations.
☐ A medical examination report completed as required for each infant, toddler, or pre-school child.
☐ A health report completed by the parent for school-age children that includes health history, current
health problems, and any restrictions necessary for care.
☐ A written diet plan for each infant and toddler, if applicable.
☐ An Individualized Care Plan, if applicable, for all children who have special needs that are not
identified on the medical examination report.
The SCCR will obtain the following documents prior to licensure:
☐ Evidence of compliance with state fire safety requirements.
☐ Evidence of compliance with state sanitation requirements.
2
(BCC-1A/Rev. 8/19)
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