Can't how the select you're looking for or need addtional information?
Please contact the Region Child Development Office nearest you.
- Application by Certificate of Compliance: Centered, Group, and Lineage Home
- Disclosure Statement:Application for Employment, Including Provisional Employment
- Child Care Working Test Form
- CD 208: Child Service Report
- CD 51: Child Health Assessment
- CD 322: Child Care Staff Health Assessment
- CD 340: Child Care Staff Evidence Worksheet
- CD 356: Alarm Drill Log | Español
- CD 357: Documentation concerning Emergency Plan Delivery | Español
- CD 357: Request For Waiver of Child Care Device Regulation
- CY 142: Child Care Employee Data Sheet
- CY 321: Day Care Agreement
- CY 862: Medication Logged
- CY 863: Verbally Request for Release of Child
- CY 864: Fire Bore Log
- CY 866: Incident Report Form
- CY 867: Emergency Contact/Parental Consent Form
- CY 113: Pennsylvania Child Abuse My Approval
- CY999: Consent/Release of Information Authorization Form
- SP 4-164: Request for Criminal Record Check
- PW 29A — Day-time Tending Services Enrollment/Attendance Record
- CANDLE 355: Emergency Plan Take
- DISC 356: Emergency Drill Log
Questions regarding your PA Child Abuse Clearance application?
Contact ChildLine at
1-877-371-5422.
Yours can immediately submit your your Child Abuse History Clearance request online.