Certified family homes use their own certification application. KICCS handles CCAP documents and correction plans, while KYID/KARES handles background screening.
Agency: Cabinet for Health and Family Services; Division of Regulated Child Care (certification) and Division of Child Care (CCAP/background support) 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
Initial Certification Application for Family Child-Care Home
Form OIG-DRCC-03
Starts certification with age, health, zoning and other supporting documentation.
Applies to
Certified family child care home applicants
Who completes it
Applicant
Where it goes
Office of Inspector General, Division of Regulated Child Care, 275 E. Main Street, 5 E-F, Frankfort, KY 40621.
When to use or update
Initial certification; review the current application checklist.
Format and applicability: Official application linked on public instructions; download could not be inspected.
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 initial certification download and certified-provider evacuation-template download were inaccessible; public instructions were reviewed.
The portal page uses inconsistent DCC-93/DCC-94B labels for electronic deposit; no deposit form was selected without verification.
DCC-94E exact-format requirement applies to CCAP; use for all children is recommended in its tip sheet, not stated as universally mandatory.
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. Initial Certification Application for Family Child-Care Home (OIG-DRCC-03)
2. Written emergency/disaster evacuation plan
3. National Background Check Program / KYID-KARES guidance
4. Applicant Child Care Staff Member Waiver Agreement and Statement (DCC-500)
5. Child Care Daily Attendance Record (DCC-94E)
6. KICCS child care certificates and provider billing guidance
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 Kentucky 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.
