Benefit, Employment & Support Services

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?