DES certification for small family providers differs from ADHS group-home certification/center licensing. Subsidy contracting is another process.
Agency: Arizona Department of Health Services; Department of Economic Security Paperwork source review: September 14, 2026
Use your print window to print on paper or save as a PDF. The organizer is a planning aid for your files.
Check the form and your provider type.
An official agency form is issued or listed by the agency; that label alone does not establish mandatory use. A required state form is identified as mandatory in the cited instructions. A required record identifies information you must maintain; its format may be flexible. An optional template is a suggested format. Official instructions / portal links explain the application or record process.
Read “Applies to” and “Format and applicability” for each item. Home, group-home, center, local licensing, food-program, and subsidy requirements can differ.
Application & renewal
01
Official instructions / portal
DES Family Child Care Provider Pre-Application
Start DES certification and review eligibility documents.
Applies to
Prospective DES-certified family providers, up to four children
Who completes it
Applicant
Where it goes
Pre-application linked by DES.
When to use or update
Before certification.
Format and applicability: Public instructions link online intake; not ADHS group-home application.
Selected official forms and public instructions were reviewed on September 14, 2026. This is a practical starting list, not a complete certification of every record, retention period, local rule, or individual application.
DES and ADHS forms are not interchangeable; confirm agency and license/certification category.
The ADHS provider-forms navigation did not expose its full dynamic contents; this is a selected set, not a complete checklist.
Use the agency’s current original and revision instructions. Keep confidential child and staff records in your own secure record system.
Use this sheet to check which items apply to your program. A listed item or a checked box does not establish that your program meets licensing requirements.
Program / provider type:
Licensing office / reviewer:
Date checked / rule or packet edition:
Form or instruction
Applies? Yes / No / Ask
Received / completed
Location / next review
1. DES Family Child Care Provider Pre-Application
2. ADHS Child Care Licensing Management System
3. Emergency Information and Immunization Record Card
Ask about required format, signatures, submission, update triggers, and retention. Record the agency’s answer and the person or written source that confirmed it.
Companion to the Arizona source review dated September 14, 2026. Provider Path educational planning sheet.
Use your existing tools alongside these sources.
Keep official licensing records with your program’s business records. Provider Path’s editable agreement, handbook, and daily forms can help organize your work; check the state instructions before choosing a format.
