The DHS forms lists contain family/group-home resources alongside center and drop-in forms. Follow current licensing directions for submission; several older labels on the directory point to updated downloads.
Agency: Department of Human Services, Child Care Services 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 to Renew a License to Operate a Child Care Agency
Form HS-2012
Renew the agency license.
Applies to
Licensed child care agencies; confirm the home-specific route with licensing.
Who completes it
License holder
Where it goes
DHS licensing using the current submission instructions/eLicensing route.
When to use or update
For license renewal; exact lead time was not verified.
Format and applicability: Public directory; renewal PDF/instruction downloads did not render in this review.
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.
A licensing-directory link labeled HS-3275 opens HS-3554; download titles and numbers should be checked together.
Directory listing alone does not establish mandatory use or an update interval. Drop-in-only HS-2994 is excluded.
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 to Renew a License to Operate a Child Care Agency (HS-2012)
2. Child Care Fingerprint Applicant Information and Criminal/Juvenile History Disclosure (HS-2779)
3. Child Care Agency Emergency Preparedness Template (HS-3554)
4. Home TN-ELDS Documentation (HS-3006)
5. Child Care Provider Medical Report (HS-0120)
6. Influenza Information Notification Form (HS-3034)
7. Claim for Reimbursement — CACFP Homes Only (HS-3083)
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 Tennessee 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.
