Family child care homes use the FCC registration packet. Group child care homes use a separate licensing packet; health-record supplement expectations differ.
Agency: Department of Human Services, Benefit, Employment & Support Services Division 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 agency form
Application for Certificate of Approval for Family Child Care
Form DHS 982
Starts FCC approval and records household, substitutes and references.
Applies to
Family child care homes
Who completes it
Applicant and spouse, where applicable
Where it goes
Return to the assigned DHS licensing worker; retain a working copy.
When to use or update
Initial application or renewal as directed. The posted form tells applicants to return it within 30 days of issue.
Format and applicability: Official PDF, revision 10/97, still linked by DHS.
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.
The FCC directory is current but several linked forms have old revision dates; confirm the packet with the assigned licensing unit.
DHS 908 is optional for FCC entry; DHS's separate center/group-home page marks it required for GCC, GCH and IT entry.
A universal FCC medication, accident or subsidy billing form was not verified in this review.
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. Application for Certificate of Approval for Family Child Care (DHS 982)
2. Supplement to FCC Application (DHS 983)
3. Student's Health Record (DOE Form 14)
4. Early Childhood Pre-K Health Record Supplement (DHS 908)
5. Authorization for Background Check and to Release Information (DHS 948)
6. Medical Report (DHS 984)
Other local or agency document
Food-program / subsidy documents
Questions and next steps
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 Hawaii 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.
