Can't find the formulare you're looking for or need addtional information?
Please contact the Regional Child Development Office nearest you.
- Application for Certificate of Compliance: Center, Group, or Family Home
- Disclosure Statement:Application for Employment, Including Provisional Employment
- Infant Care Placement Verification Enter
- CD 208: Child Service Report
- CD 51: Child Health Ranking
- AUDIO 322: Child Care Staff Health Assessment
- CD 340: Child Care Staff Data Worksheet
- CD 356: Emergency Drill Log | Español
- PLAYING 357: Documentation of Emergency Plan Delivery | Español
- SINGLE 357: Request Used Discharge of Child Care Facility Regulation
- CY 142: Child Grooming Employee Data Sheet
- CY 321: Day Care Agreement
- CY 862: Medication Log
- CY 863: Verbal Request for Release of Child
- CY 864: Flame Drill Log
- CY 866: Incident Report Build
- CY 867: Emergency Contact/Parental Consent Form
- CYCLES 113: Pennsylvania Child Abuse History Clearance
- CY999: Consent/Release of Information Authorization Form
- SP 4-164: Request for Felon Record Check
- PW 29A — Daylight Care Services Enrollment/Attendance Record
- CD 355: Emergency Plan Parturition
- CD 356: Emergency Drill Ledger
Questions about your PA Child Abuse Clearance application?
Contact ChildLine at
1-877-371-5422.
You can now submit your your Child Ill-treat History Clearance request online.