Change of Ownership Applicant Guide - Bright from the Start

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Type of Ownership (Check one) Tax Status (Check one) Individual/ Sole Proprietor Corporation/ LLC Profit Partnership Board-Sponsored Nonprofit SSN (individual owner) or EIN # (corporation/LLC) :______________________________________ Corporation/LLC: Submit a copy of corporation papers, i.e. Certificate of Inc./Org., Articles & By-Laws Board-Sponsored: Submit a list of board members & minutes from most recent meeting. E-mail Address Complete the following: Is facility currently operating? Yes No (NOTE: If no, operation must resume within 30 days of previous owner suspending operation in order to be considered a change of ownership.) Provide former license number and former program name: Former License # _________________________________________________________________ Former Program Name _____________________________________________________________ If no, list date facility stopped operating: _______________________________________________ Person Legally Responsible and Official Address for all Communications: Name Street or P.O. Box City/State/Zip Telephone No. Email Address Name and Address of Agent for Service (for corporations & LLCs registered with the Secretary of State) for Facility: Name Street or P.O. Box City/State/Zip Email Address
Exemptions Do you own any exempted childcare facilities in the State of Georgia? Yes No If yes, list the official name and address of the exempted program. _________________________________________ Name _________________________________________ Site Address Schedule: Months of Operation: ________________________ Days of Operation: ________________________ Hours of Operation: ________________________ Check all services that apply: Building Owner Do you own the building in which the program is housed? Yes No If no, list the landlord’s name and address: _______________________________________ Landlord’s Name _______________________________________ Landlord’s Mailing Address Attach a copy of the current lease agreement, if applicable Age Range of Children to be Served: From__________________________ To____________________________ Infants & Toddlers (Ages 0-2) School-age summer care Special Needs CACFP Preschoolers (ages 3-4) Evening Care Transportation-field trips Drop-in care School Age (Ages 5+) Night Care Transportation-school Accepts Subsidies School Age Only Mildly Ill Care Transportation-home Other Facility/ Site Director: Name:_____________________________________________________________________________ Date of birth___________________________________ SSN________________________________ Preliminary criminal records check results are attached? Yes No Criminal Records Check Application/Fingerprints submitted on______________________________ (Date) Upon receipt and review of a completed application, a child care consultant will conduct an inspection of the center. This inspection includes an assessment of compliance with Rules and Regulations for Child Care Learning Centers/Group Day Care Homes to include an evaluation of the physical plant, staffing, records, and services. A. I/We will ensure that the center adheres to all licensing requirements. B. I/We understand that a license to operate a center is not transferable to another individual or location. C. I/We understand that the issuance of a new license may be denied for failure to comply with licensing requirements. D. I/We understand that the center is subject to unannounced inspections by Bright from the Start: Georgia Department of Early Care and Learning at any time during operating hours.
Page 1 and 2: Change of Ownership Licensing Appli
Page 3 and 4: Section F: Operation Plan Operation
Page 5 and 6: STEPS FOR SUCCESSFUL CHANGE OF OWNE
Page 7 and 8: LICENSE FEE MUST BE SUBMITTED PRIOR
Page 9: BRIGHT FROM THE START: GEORGIA DEPA
Page 13 and 14: License Number Bright from the Star
Page 15 and 16: INSTRUCTIONS FOR COMPLETING THE APP
Page 17 and 18: children you propose to serve (6 we
Page 19 and 20: Section C: Criminal Records Checks
Page 21 and 22: submit a new national fingerprint c
Page 23 and 24: BRIGHT FROM THE START Georgia Depar
Page 25 and 26: Section D: Floor Plan Sample Floor
Page 27 and 28: WINDOWS WINDOW SPACE REQUIREMENTS F
Page 29 and 30: MIXED-AGE GROUPS FOR CHILD CARE LEA
Page 31 and 32: CHILDREN’S STORAGE STORAGE SPACE/
Page 33 and 34: • If your facility plans to have
Page 36 and 37: GROUND COVERING ● Choose from a v
Page 38 and 39: PLAY EQUIPMENT AND SURFACES ● Pro
Page 40 and 41: FALL ZONE An area extending four fe
Page 42 and 43: (Merry-Go-Rounds, rotating teeter t
Page 44 and 45: Broken/missing steps/rungs/hand rai
Page 46 and 47: The Operation Plan Checklist has be
Page 48 and 49: EMPLOYEE FILES During your Initial
Page 50 and 51: __ 10. Handling emergency medical c
Page 52 and 53: Children's Files The following item
Page 54 and 55: Your menu should include clearly id
Page 56 and 57: Section G: SAMPLE FORMS
Page 58 and 59: Sample Staff Forms
Page 60 and 61:
PLEASE LIST EMPLOYMENT HISTORY FOR
Page 62 and 63:
DOCUMENTATION OF ORIENTATION (Condu
Page 64 and 65:
Additional Staff Policies & Procedu
Page 66 and 67:
SAMPLE CHILDREN’S ENROLLMENT FORM
Page 68 and 69:
Parental Agreements with Child Care
Page 70 and 71:
INFANT FEEDING PLAN Child’s full
Page 72 and 73:
REQUIRED REPORT OF INCIDENT Consult
Page 74 and 75:
Food Service Forms
Page 78 and 79:
Breakfast AM Snack Lunch PM Snack W
Page 80 and 81:
Manual Dishwashing - Chemical Metho
Page 82 and 83:
ITEMS TO BE POSTED
Page 84:
PARENTS YOU HAVE THE RIGHT: 1. To a
Page 93 and 94:
NOTICE TO PARENTS AND VISITORS: The
Page 95 and 96:
TRANSPORTATION GUIDELINES To provid
Page 97 and 98:
This is to certify that I give perm
Page 99:
VEHICLE EMERGENCY MEDICAL INFORMATI
Page 108 and 109:
Child Care Resource and Referral Ag
Page 111 and 112:
2 Martin Luther King Jr. Drive, SE
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Change of Ownership Applicant Guide - Bright from the Start

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