Sub-Category

Name

Number

Date

Autism Spectrum Disorders: Learn the Signs (Poster)

2010

Legally-Exempt Provider

District Notification to Legally -Exempt Caregiver Enrollment Agency

OCFS-2114

2011

Legally-Exempt Provider

History of Criminal Convictions and Parental Acknowledgment

OCFS-4915

2012

Legally-Exempt Provider

Historial de Convicciones Criminales y Reconocimiento del Padre-Madre History of Criminal Convictions and Paternal Acknowledgment

OCFS-4915-S

2012

Legally-Exempt Provider

History of Day Care Enforcement and Parental Acknowledgment

OCFS-4916

2012

Legally-Exempt Provider

Historial de Ejecutoria de Cuidado Diurno y Reconocimiento del Padre-Madre History of Day Care Enforcement and Parental Acknowledgment

OCFS-4916-S

2012

Legally-Exempt Provider

History of Termination of Parental Rights and or Court Ordered Article 10/Removal of a Child and Parental Acknowledgment

OCFS-4917

2012

Legally-Exempt Provider

OCFS-4917-S Historial de Terminacion de Derechos Paternos/Maternos y/o Retiro de Ninos por Orden del Tribunal Segun Articulo 10 y Reconocimiento Paterno-Materno History of Termination of Parental Rights and/or Court Ordered Article 10/Removal of a Child and Parental Acnowledgement

OCFS-4917-S

2012

Legally-Exempt Provider

Enrollment Information Packet for Legally-Exempt Providers(WORD)

OCFS-7026

2007

Legally-Exempt Provider

Paquete de Informacion Sobre la Inscripcion para Proveedores Legalmente Exentos(WORD)

OCFS-7026-S

2007

Legally-Exempt Provider

ENROLLMENT FORM FOR PROVIDER OF LEGALLY-EXEMPT FAMILY CHILD CARE AND LEGALLY-EXEMPT IN-HOME CHILD CARE(WORD)

OCFS-LDSS-4699

2006

Legally-Exempt Provider

Employment of Minors Form(WORD)

OCFS-LDSS-4699-1

2006

Legally-Exempt Provider

Employment of Minors Information(WORD)

OCFS-LDSS-4699-1A

2006

Legally-Exempt Provider

Formulario de Empleo para Menores de Edad(WORD) Employment of Minors Form

OCFS-LDSS-4699-1-S

2006

Legally-Exempt Provider

Legally-Exempt In-Home Child Care Provider Agreement Form(WORD)

OCFS-LDSS-4699-2

2006

Legally-Exempt Provider

Parental Responsibilities When Employing a Legally-Exempt In-Home Child Care Provider(WORD)

OCFS-LDSS-4699-2A

2006

Legally-Exempt Provider

Acuerdo del Proveedor(a) de Cuidado Infantil a Domicilio Legalmente Exento

OCFS-LDSS-4699-2S

2012

Legally-Exempt Provider

Legally-Exempt Provider Training Record Form

OCFS-LDSS-4699-3

2006

Legally-Exempt Provider

Registro de Entrenamiento para Proveedores de Cuidado Infantil Legalmente Exento(WORD) Legally-Exempt Provider Training Record Form

OCFS-LDSS-4699-3-S

2006

Legally-Exempt Provider

Formulario de Inscripcion para Proveedor(a) de Servicios de Cuidado Infantil en Familia Legalmente Exento y de Cuidado Infantil a Domicilio(WORD)

OCFS-LDSS-4699S

2011

Legally-Exempt Provider

ENROLLMENT FORM FOR PROVIDER OF LEGALLY-EXEMPT GROUP CHILD CARE(WORD)

OCFS-LDSS-4700

2012

Legally-Exempt Provider

Health Care Plan for the Administration of Medication for Legally-Exempt Provider(WORD)

OCFS-LDSS-7000

2008

Legally-Exempt Provider

Instrucciones para Completar el Plan de Salud para la Administracion de Medicamentos para Proveedores Legalmente Exentos(WORD)

OCFS-LDSS-7000S

2008

Legally-Exempt Provider

Instructions for Completing the Health Care Plan for the Administration of Medication for Legally-Exempt Provider(WORD)

OCFS-LDSS-7001

2008

Legally-Exempt Provider

Instrucciones para Completar el Plan de Salud para la Administracion de Medicamentos del Proveedor Legalmente Exento(WORD)

OCFS-LDSS-7001S

2004

Legally-Exempt Provider

Written Medication Consent Form(WORD)

OCFS-LDSS-7002

2004

Legally-Exempt Provider

Formulario de Consentimiento Escrito para Medicamentos Written Medication Consent Form

OCFS-LDSS-7002S

2004

Legally-Exempt Provider

Verbal Medication Consent Form and Log of Administration(WORD)

OCFS-LDSS-7003

2004

Legally-Exempt Provider

Formulario de Consentimiento Verbal y Administación del Registro(WORD) Verbal Medication Consent Form and Log of Administration

OCFS-LDSS-7003S

2004

Legally-Exempt Provider

Log of Medication Administration(WORD)

OCFS-LDSS-7004

2004

Legally-Exempt Provider

Registro de Administración de Medicamentos(WORD) Log of Medication Administration

OCFS-LDSS-7004S

2004

Legally-Exempt Provider

Medication Error Report Form(WORD)

OCFS-LDSS-7005

2004

Legally-Exempt Provider

Formulario de Informe de Error de Medicación(WORD) Medication Error Report Form

OCFS-LDSS-7005S

2004

Legally-Exempt Provider

Individual Health Care Plan for A Child With Special Health Care Needs(WORD)

OCFS-LDSS-7006

2004

Legally-Exempt Provider

Plan Individual de Cuidado de la Salud para un Niño(a) con Necesidades Especiales de Cuidado de la Salud(WORD) Individual Health Care Plan for a Child with Special Health Care Needs

OCFS-LDSS-7006S

2004

Legally-Exempt Provider

Obtaining Authorization to Administer Medication to Subsidized Children in Legally Exempt Care(WORD)

OCFS-LDSS-7007

2008

Legally-Exempt Provider

Obtención de Autorización para la Administración de Medicamentos para Niños Subsidiados en Cuidado Infantil Legalmente Exento

OCFS-LDSS-7007S

2008

Legally-Exempt Provider

Administration of Medication by Legally-Exempt Child Care Provider(WORD)

OCFS-LDSS-7008

2004

Legally-Exempt Provider

Administración de Medicamentos por el Proveedor de Cuidado Infantil Legalmente Exento(WORD) Administration of Administration by Legally Exempt Provider

OCFS-LDSS-7008S

2004

Legally-Exempt Provider

Home Inspection Report for Legally Exempt Family Child Care Provider(WORD)

OCFS-LDSS-7028-1

2013

Legally-Exempt Provider

Corrective Action Plan for Legally Exempt Child Care Provider(WORD)

OCFS-LDSS-7028-2

2008

Legally-Exempt Provider

Attachment to the Home Inspection Report for Legally Exempt Family Child Care Provider(WORD)

OCFS-LDSS-7028-3

2008

Licensed/Registered Provider

Caregiver Medical Statement (All Modalities) (WORD)

LDSS-4434-1

2011

Licensed/Registered Provider

Household Member Medical Statement(WORD)

LDSS-4434-4

2009

Licensed/Registered Provider

Incident Report for Child Day Care(WORD)

LDSS-4436

2011

Licensed/Registered Provider

DCC Emergency Planning Guide

LDSS-4438DCC

2011

Licensed/Registered Provider

FDC-GFDC Emergency Planning Guide

LDSS-4438FDC

2011

Licensed/Registered Provider

SACC Emergency Planning Guide

LDSS-4438SACC

2011

Licensed/Registered Provider

Record of Fire Drills for Child Day Care(WORD)

LDSS-4439

2005

Licensed/Registered Provider

Schedule of Program Activities for Child Day Care(WORD)

LDSS-4440

2004

Licensed/Registered Provider

Discipline Policy Statement for Child Day Care(WORD)

LDSS-4441

2005

Licensed/Registered Provider

Menu Planning for Child Day Care(WORD)

LDSS-4442

2005

Licensed/Registered Provider

Daily Attendance Record Child Day Care(WORD)

LDSS-4443

2004

Licensed/Registered Provider

Potassium Iodide-KI Refusal-Opt-Out Form(WORD)

OCFS-4411

2011

Licensed/Registered Provider

Formulario para Rehusar el Yoduro de Potasio (KI) (WORD) Potassium Iodide (KI) Refusal/Opt-Out Form

OCFS-4411S

2011

Licensed/Registered Provider

Notice to Expunge Associated Fingerprint Cards(WORD)

OCFS-4622

2010

Licensed/Registered Provider

Waiver for Submission of a Duplicate Fingerprint Card(WORD)

OCFS-4659

2011

Licensed/Registered Provider

Day Care Program Training Tracking Chart(WORD)

OCFS-4879

2008

Licensed/Registered Provider

Hoja para Registrar la Capacitacion del Personal en un Programa de Cuidado Diurno(WORD)

OCFS-4879S

2008

Licensed/Registered Provider

Individual Training Tracking Form for Child Care Personnel(WORD)

OCFS-4880

2008

Licensed/Registered Provider

HOJA PARA REGISTRAR LA CAPACITACION INDIVIDUAL EN UN PROGRAMA DE CUIDADO DIURNO(WORD)

OCFS-4880S

2008

Licensed/Registered Provider

Request for Waiver(WORD)

OCFS-4887

2011

Licensed/Registered Provider

Hoja para Registrar la Capacitacion Individual en un Programa de Cuidado Diurno (WORD)

OCFS-4887S

2011

Licensed/Registered Provider

Report of Death of Child Care(WORD)

OCFS-4890

2008

Licensed/Registered Provider

Fuel Burning System Inspection(WORD)

OCFS-4926

2010

Licensed/Registered Provider

ASFA Request for NYS Fingerprinting Services - Information Form (WORD)

OCFS-4930

2013

Licensed/Registered Provider

Guidelines for Fingerprinting (WORD)

OCFS-4930-1

2013

Licensed/Registered Provider

Guia para Obtener Impresiones Digitales(WORD)

OCFS-4930-1S

2013

Licensed/Registered Provider

Solicitud de Servicios de Impresiones Digitales Request for Fingerprinting Services

OCFS-4930S

2013

Licensed/Registered Provider

FAMILY AND GROUP FAMILY DAY CARE PROVIDER REQUEST TO REMOVE STREET ADDRESS AND MAP FROM THE OFFICE OF CHILDREN AND FAMILY SERVICES WEBSITE(WORD)

OCFS-4932

2009

Licensed/Registered Provider

Solicitud para Retirar del Portal de la Agencia la Dirección y el Mapa Asociado con la Dirección de un Hogar de Cuidado Diurno en Familia o de un Grupo en Familia Family and Group Family Day Care Provider Request to Remove Street Address and Map from the Office of Children and Family Services Website Family Group and Family Day Care Provider Request to Remove Street Addres and Map from Office of Children and Family Services Website

OCFS-4932S

2009

Licensed/Registered Provider

Provider Notification of Licensing or Registration to Fire and Police or Sheriff Departments(WORD)

OCFS-4939

2010

Licensed/Registered Provider

Notificacion del Proveedor(a) de Cuidado Infantil a los Departamentos de Bomberos y de la Policia sobre su Licencia o Registro(WORD)

OCFS-4939S

2010

Licensed/Registered Provider

DCC-Monthly Fire-Safety Inspection for DCC Director or Designee

OCFS-DCC-4838

2012

Licensed/Registered Provider

Medical Statement of Child in Childcare(WORD)

OCFS-LDSS-4433

2008

Licensed/Registered Provider

Written Medication Consent Form(WORD)

OCFS-LDSS-7002

2004

Licensed/Registered Provider

Formulario de Consentimiento Escrito para Medicamentos Written Medication Consent Form

OCFS-LDSS-7002S

2004

Licensed/Registered Provider

Verbal Medication Consent Form and Log of Administration(WORD)

OCFS-LDSS-7003

2004

Licensed/Registered Provider

Formulario de Consentimiento Verbal y Administacion del Registro(WORD) Verbal Medication Consent Form and Log of Administration

OCFS-LDSS-7003S

2004

Licensed/Registered Provider

Log of Medication Administration(WORD)

OCFS-LDSS-7004

2004

Licensed/Registered Provider

Registro de Administración de Medicamentos(WORD) Log of Medication Administration

OCFS-LDSS-7004S

2004

Licensed/Registered Provider

Medication Error Report Form(WORD)

OCFS-LDSS-7005

2004

Licensed/Registered Provider

Formulario de Informe de Error de Medicacion(WORD) Medication Error Report

OCFS-LDSS-7005S

2004

Licensed/Registered Provider

Individual Health Care Plan for A Child With Special Health Care Needs(WORD)

OCFS-LDSS-7006

2004

Licensed/Registered Provider

Plan Individual de Cuidado de la Salud para un Nino(a) con Necesidades Especiales de Cuidado de la Salud(WORD) Individual Health Care Plan for a Child with Special Health Care Needs

OCFS-LDSS-7006S

2004

Licensed/Registered Provider

Illness Injury and Indicators of Abuse Log(WORD)

OCFS-LDSS-7019

2010

Licensed/Registered Provider

Registro de Enfermedades, Lesiones e Indicadores de Abuso Illness, Injury and Indicators of Abuse Log

OCFS-LDSS-7019S

2006

Licensed/Registered Provider

Health Care Plan - Day Care Center(WORD)

OCFS-LDSS-7020

2010

Licensed/Registered Provider

Plan de Atencion Medica-Centro de Cuidado Infantil-Guarderia Infantil(WORD) Health Care Plan-Day Care Center

OCFS-LDSS-7020S

2010

Licensed/Registered Provider

Health Care Plan - Family Day Care Center - Group Family Day Care Center - Small Day Care Centers(WORD)

OCFS-LDSS-7021

2010

Licensed/Registered Provider

Plan de Atencion Medica - Hogar de Cuidado Diurno en Familia - Hogar de Cuidado Diurno de un Grupo en Familia - Centro Pequeno de Cuidado Infantil(WORD) Health Care Plan-Family Day Care Center-Group Family Day Care Center-Small Day Care Centers

OCFS-LDSS-7021S

2010

Licensed/Registered Provider

Health Care Plan - School Age Child Care(WORD)

OCFS-LDSS-7022

2010

Licensed/Registered Provider

Evaluation of my Most Recent Licensing-Registration Experience(WORD)

OCFS-LDSS-7024

2009

Licensed/Registered Provider

Assistant Information-Group Family Day Care(WORD)

OCFS-LDSS-7035

2008

Licensed/Registered Provider

Assistant Qualifications(WORD)

OCFS-LDSS-7036

2008

Licensed/Registered Provider

Assistant References(WORD)

OCFS-LDSS-7037

2008

Licensed/Registered Provider

Criminal Conviction Statement(WORD)

OCFS-LDSS-7038

2012

Licensed/Registered Provider

Environmental Hazards Guidance Sheet(WORD)

OCFS-LDSS-7040

2006

Licensed/Registered Provider

Directions for Completing the Environmental Hazards Statement(WORD)

OCFS-LDSS-7041

2006

Licensed/Registered Provider

Environmental Hazard Information Form Parts I and II(WORD)

OCFS-LDSS-7042

2006

Licensed/Registered Provider

Plan of Study Commitment for Head of Group for Preschoolers Infants and Toddlers(WORD)

OCFS-LDSS-7043

2008

Licensed/Registered Provider

Plan of Study Commitment for Director of Day Care Center(WORD)

OCFS-LDSS-7044

2008

Licensed/Registered Provider

SACC-Monthly Fire-Safety Inspection for DCC Director or Designee

OCFS-SACC-4838

2012

Local Department of Social Services

Instructions for Completing the Statewide Central Register Database Check Form (DCCS Version)

LDSS-3370

2011

Local Department of Social Services

CHILD CARE ELIGIBLITY RE-DETERMINATION COMING DUE (Sample Only)

OCFS-4773

2013

Local Department of Social Services

Se Acerca la Rederminación de Su Elegibilidad para Recibir Asistencia de Cuidado Infantil (Ejemplo Solamente) Child Care Eligibility Re-determination Coming Due (Sample Only)

OCFS-4773S

2013

Local Department of Social Services

Day Care Registration(WORD)

OCFS-LDSS-0792

2005

Local Department of Social Services

Registro de Cuidado Diurno Day Care Registration

OCFS-LDSS-0792-S

2012

Local Department of Social Services

Registro de Cuidado Diurno Day Care Registration

OCFS-LDSS-0792-S

2012

Local Department of Social Services

Medical Statement of Child in Childcare(WORD)

OCFS-LDSS-4433

2008

Local Department of Social Services

APPROVAL OF YOUR APPLICATION FOR CHILD CARE BENEFITS (Sample Only)

OCFS-LDSS-4779

2013

Local Department of Social Services

Aprobación de Su Solicitud para Beneficios de Cuidado Infantil (Ejemplo Solamente) Approval of Your Application for Child Care Benefits (Sample Only)

OCFS-LDSS-4779-S

2013

Local Department of Social Services

DENIAL OF YOUR APPLICATION FOR CHILD CARE BENEFITS (Sample Only)

OCFS-LDSS-4780

2013

Local Department of Social Services

Notificación del Intento de Cambiar Beneficios de Cuidado Infantil y Pagos de Porciones Familiares (Ejemplo Solamente) Notice of Intent to Change Child Care Benefits and Family Share Payments (Sample Only)

OCFS-LDSS-4780-S

2012

Local Department of Social Services

NOTICE OF INTENT TO CHANGE CHILD CARE BENEFITS AND FAMILY SHARE PAYMENTS (Sample Only)

OCFS-LDSS-4781

2013

Local Department of Social Services

Notificación del Intento de Cambiar Beneficios de Cuidado Infantil y Pagos de Porciones Familiares (Ejemplo Solamente) Notice of Intent to Change Child Care Benefits and Family Share Payments (Sample Only)

OCFS-LDSS-4781S

2013

Local Department of Social Services

NOTICE OF INTENT TO DISCONTINUE CHILD CARE BENEFITS (Sample Only)

OCFS-LDSS-4782

2013

Local Department of Social Services

Notificación del Intento de Discontinuar los Beneficios de Cuidado Infantil (Ejemplo Solamente) Notice of Intent to Discontinue Child Care Benefits (Sample Only)

OCFS-LDSS-4782-S

2013

Local Department of Social Services

Delinquent Family Share for Child Care Benefits

OCFS-LDSS-4783

2012

Local Department of Social Services

Delinquent Family Share for Child Care Benefits 托兒補助家庭自付額欠款通知

OCFS-LDSS-4783-CH

2013

Local Department of Social Services

Delinquent Family Share for Child Care Benefits 托兒補助家庭自付額欠款通知

OCFS-LDSS-4783-CH

2013

Local Department of Social Services

Delinquent Family Share for Child Care Benefits KONTRIBISYON PEMAN FANMI KI ANRETA POU BENEFIS GADRI

OCFS-LDSS-4783-HC

2013

Local Department of Social Services

Delinquent Family Share for Child Care Benefits KONTRIBISYON PEMAN FANMI KI ANRETA POU BENEFIS GADRI

OCFS-LDSS-4783-HC

2013

Local Department of Social Services

Delinquent Family Share for Child Care Benefits INSOLVENZA PER IL CONTRIBUTO FAMILIARE PER SUSSIDI PER I SERVIZI ALL'INFANZIA

OCFS-LDSS-4783-IT

2013

Local Department of Social Services

Delinquent Family Share for Child Care Benefits INSOLVENZA PER IL CONTRIBUTO FAMILIARE PER SUSSIDI PER I SERVIZI ALL'INFANZIA

OCFS-LDSS-4783-IT

2013

Local Department of Social Services

Delinquent Family Share for Child Care Benefits 아동 보호 수당에 요구되는 가족 부담액의 연체

OCFS-LDSS-4783-KO

2013

Local Department of Social Services

Delinquent Family Share for Child Care Benefits 아동 보호 수당에 요구되는 가족 부담액의 연체

OCFS-LDSS-4783-KO

2013

Local Department of Social Services

Delinquent Family Share for Child Care Benefits ПРОСРОЧЕННЫЙ СЕМЕЙНЫЙ ВЗНОС В СЧЕТ ПОСОБИЯ ПО УХОДУ ЗА РЕБЕНКОМ

OCFS-LDSS-4783-RU

2013

Local Department of Social Services

Delinquent Family Share for Child Care Benefits ПРОСРОЧЕННЫЙ СЕМЕЙНЫЙ ВЗНОС В СЧЕТ ПОСОБИЯ ПО УХОДУ ЗА РЕБЕНКОМ

OCFS-LDSS-4783-RU

2013

Local Department of Social Services

Porción de Pago Familiar en Delincuencia para Cubrir Beneficios de Cuidado de Niños

OCFS-LDSS-4783-S

2012

Local Department of Social Services

Notice of Child Care Assistance Overpayment and Repayment Requirements(WORD)

OCFS-LDSS-7009

2005

Local Department of Social Services

Notificación de Sobrepago de Asistencia para Cuidado Infantil y Requisitos de Devolución(WORD) Notice of Child Care Assistance Overpayment and Repayment Requirements

OCFS-LDSS-7009S

2005

Local Department of Social Services

Notice of Fraud Determination-Disqualification for Child Care Benefits and Repayment Plan(WORD)

OCFS-LDSS-7010

2005

Local Department of Social Services

Notificación de Determinación de Fraude Descalificación para Recibir Beneficios de Cuidado Infantil y Plan de Devolución de Pagos(WORD) Notice of Fraud Determination-Disqualification for Child Care Payments and Repayment Plan

OCFS-LDSS-7010S

2005