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Home » Child Care Program » Child Care Licensing » Family Child Care Home (FCC) Registration Forms

Family Child Care Home (FCC) Registration Forms

Application Forms and Instructions for FCC:

  • DOE Form 14 Child’s Health Record (or comparable documentation)
  • DHS 908 Early Childhood Pre-K Health Record Supplement (rev 9/15)
    • not required for entry into the FCC, but highly recommended for all children submitting DOE Form 14
  • DHS 908A Instructions for DHS 908_(rev 9/15)
  • DHS 948 Authorization for Background Check and to Release Information (fillable .pdf)
  • DHS 948A Instructions
  • DHS 948B Non-Criminal Justice Applicant Privacy Rights
  • DHS 959 Employment History Form
  • DHS 959A Self-Certification of Employment
  • DHS 958 Instructions for Employment History Clearance
  • DHS 961A Instructions for Background Checks Oahu
  • DHS 961D Instructions for Background Checks Neighbor Island
  • DHS 962 Synopsis of Criminal History Law Requirements
  • DHS 982 Application for Certificate of Approval for Family Child Care (FCC)
  • DHS 983 Supplement to FCC Application
  • DHS 984 Medical Report (for applicants and adult household members)
  • DHS 984A Instructions for the Medical Report Form for FCC

 

Other Registration Forms:

  • DHS 974 Notification of Change(s) Form (FCC)
  • DHS 980 Guide for FCC Registration
  • DHS 981 Do You Want to Operate a Family Child Care Home?

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