Form BCC-2A "Checklist for Initial Applicant(S) for a Child Care Home License" - Missouri

What Is Form BCC-2A?

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-2A 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-2A "Checklist for Initial Applicant(S) for a Child Care Home License" - Missouri

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Section for Child Care Regulation
CHECKLIST FOR INITIAL APPLICANT(S) FOR A CHILD CARE HOME LICENSE
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 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 the indoor space; location of toilet
and handwashing sinks, kitchen, and exits. 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 regarding 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.
☐ A sample weekly menu.
☐ An itemized list of available materials and equipment to be used by the children.
☐ Sample forms used in the daily operation of the facility that are not supplied by the SCCR.
☐ If not privately owned, a copy of the Articles of Incorporation, Certificate of Incorporation, 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.
☐ Approved assistant(s) who may be used at any time during the licensing period.
☐ Other information required by the SCCR to make a determination regarding licensure of the facility.
Note: Please keep a copy of all submitted documents for your records.
The applicant must have verification of the following on file at the facility:
☐ Applicant’s completed medical examination report and Tuberculosis (TB) Risk Assessment form as required; and
☐ Completed medical examination reports and Tuberculosis (TB) Risk Assessment form for any assistant and/or
volunteer who is present at the facility more than 20 hours per month.
☐ Required comprehensive criminal background check results for applicant, assistants, and household members
17 years and older.
Evidence of completion of department-approved safe sleep training for the provider and all assistants, if
requesting licensure for children under 12 months of age.
Evidence of age-appropriate CPR/First Aid certification on file for applicant and assistants.
1
(BCC-2A/Rev. 8/19)
Section for Child Care Regulation
CHECKLIST FOR INITIAL APPLICANT(S) FOR A CHILD CARE HOME LICENSE
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 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 the indoor space; location of toilet
and handwashing sinks, kitchen, and exits. 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 regarding 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.
☐ A sample weekly menu.
☐ An itemized list of available materials and equipment to be used by the children.
☐ Sample forms used in the daily operation of the facility that are not supplied by the SCCR.
☐ If not privately owned, a copy of the Articles of Incorporation, Certificate of Incorporation, 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.
☐ Approved assistant(s) who may be used at any time during the licensing period.
☐ Other information required by the SCCR to make a determination regarding licensure of the facility.
Note: Please keep a copy of all submitted documents for your records.
The applicant must have verification of the following on file at the facility:
☐ Applicant’s completed medical examination report and Tuberculosis (TB) Risk Assessment form as required; and
☐ Completed medical examination reports and Tuberculosis (TB) Risk Assessment form for any assistant and/or
volunteer who is present at the facility more than 20 hours per month.
☐ Required comprehensive criminal background check results for applicant, assistants, and household members
17 years and older.
Evidence of completion of department-approved safe sleep training for the provider and all assistants, if
requesting licensure for children under 12 months of age.
Evidence of age-appropriate CPR/First Aid certification on file for applicant and assistants.
1
(BCC-2A/Rev. 8/19)
Verification of current Class E, CDL, or Commercial Driver’s license for all adults who transport children.
The applicant must have verification of the below on file at the facility for children in care:
A completed enrollment form, which includes identifying information, field trip information, 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.
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-2A/Rev. 8/19)
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