Family Home Child Care Request to Change Capacity Information below to be completed by licensee. Printed licensee’s name Provider ID # Anniversary date I request capacity change in the number of children that I am licensed for WAC 110-300B-5700 Current Age range Number under Requested Age range Number under licensed two years of age capacity two years of capacity age Complete the following information: Indoor play I have square feet of licensed play space for children in my home. This does not include hallways, bathrooms, or closets. A minimum of 35 sq. ft. per child is required by WAC 110-300B-4225. Outdoor Play Space: I have square feet of fenced useable outdoor play space at my home. A minimum of 75 sq. ft. per child is required by WAC 110-300B-4925. Equipment: I have a sufficient quantity and variety of appropriate indoor/outdoor play equipment for children required by WAC 110-300B-5000 and Attach a sample list of your learning and play materials to this request. Nap Equipment: I have # mats, cots, beds, cribs, and/or playpens for napping children by WAC 170-296A-3750. Licensee information: of First aid expiration CPR expiration HIV/AIDS Total hours of STARS (Child licensed date date training ongoing training Care Basics) experience date List all staff: STARS TB CPR First Aid Background HIV/AIDS (Child Name Resume test expiration expiration authorization training Care result date date submitted Basics) Attach copies of documentation for your DCYF file of Early Childhood Education classes taken by you and your primary assistant. Include documentation of STARS training completed. (See WAC 110-300B-1175, 110-300B-1800 and 110-300B-1910)
Family Home Child Care Request to Change Capacity Information below to be completed by licensee. Printed licensee’s name Provider ID # Anniversary date I request capacity change in the number of children that I am licensed for WAC 110-300B-5700 Current licensed capacity Age range Number under two years of age Requested capacity Age range Number under two years of age Complete the following information: Indoor play I have square feet of licensed play space for children in my home. This does not include hallways, bathrooms, or closets. A minimum of 35 sq. ft. per child is required by WAC 110-300B-4225. Outdoor Play Space: I have square feet of fenced useable outdoor play space at my home. A minimum of 75 sq. ft. per child is required by WAC 110-300B-4925. Equipment: I have a sufficient quantity and variety of appropriate indoor/outdoor play equipment for children required by WAC 110-300B-5000 and Attach a sample list of your learning and play materials to this request. Nap Equipment: I have # mats, cots, beds, cribs, and/or playpens for napping children by WAC 170-296A-3750. Licensee information: of licensed experience First aid expiration date CPR expiration date HIV/AIDS training date Total hours of ongoing training STARS (Child Care Basics) List all staff: Name Resume TB test result CPR expiration date First Aid expiration date HIV/AIDS training STARS (Child Care Basics) Background authorization submitted Attach copies of documentation for your DCYF file of Early Childhood Education classes taken by you and your primary assistant. Include documentation of STARS training completed. (See WAC 110-300B-1175, 110-300B-1800 and 110-300B-1910)
10.9.3.8FHChangeCapacity.docx