Child Care Center Licensing Forms


Application Forms and Instructions for Before & After School Child Care Facility (BAS), Group Child Care Center (GCC), Group Child Care Home (GCH), and Infant & Toddler Child Care Center (IT):

DHS 948 Authorization for Background Check and to Release Information (fillable .pdf)

DHS 948A Instructions

DHS 948B Non-Criminal Justice Applicant Privacy Rights

DHS 951 Application for License to Operate a Group Child Care Center or Group Child Care Home

DHS 952 Statement of Operation Policies

DHS 953 Statement of Legal Authority

DHS 954 Child Care Center Staff and Volunteer Listing

DHS 957 Staff Sequence Form

DHS 958 Instructions for Employment History Clearance

DHS 959 Employment History Form

DHS 959A Self-Certification of Employment

DHS 961A Instructions for Background Checks Oahu

DHS 961D Instructions for Background Checks Neighbor Island

DHS 962 Synopsis of Criminal History Law Requirements

DHS 969 Child Care Licensing Self-Certification Form


Other Licensing Forms:

DOE Form 14 Child’s Health Record (or comparable documentation)

DHS 908 Early Childhood Pre-K Health Record Supplement (rev 9/15)  (required for entry into the GCC, GCH, and IT)

DHS 908A Instructions for DHS 908_(rev 9/15)

DHS 950 Guide for GCC, GCH, BAS, IT Licensing

DHS 970 Reference Guide for Preschool Staff Qualifications

DHS 971 Reference Guide for Infant/Toddler Staff Qualifications

DHS 972 Reference Guide for Before/After School Care Staff Qualifications

DHS 974 A Notification of Change(s) Form (BAS, GCC, GCH, IT)

DHS 975 Request to Increase or Determine License Capacity and Agreement

DHS 975 A Instructions for DHS 975

DHS 984 Medical Report

DHS 984B Instructions for the Medical Report Form