Change of Ownership Applicant Guide - Bright from the Start

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SAMPLE CHILDREN’S ENROLLMENT FORM Page 1 of 3 Entrance Date Withdrawal Date Child’s Name Sex Age Date of birth Home Address (Street) City State Zip Home Phone Number Father’s Name Home Phone Number Father’s Home Address (if different from child’s) Street City State Zip Father’s Place of Employment Work Phone Employer’s Street Address City State Zip Mother’s Name Home Phone Number Mother’s Home Address (if different from child’s) Street City State Zip Mother’s Place of Employment Work Phone # Employer’s Street Address_________________________City_____ __ ___State______Zip__ _____ Child’s Living Arrangements: (check one) ( ) Both Parents ( ) Mother ( ) Father ( ) Other Child’s Legal Guardian(s): (check one) ( ) Both Parents ( ) Mother ( ) Father ( ) Other The child may be released to the person(s) signing this agreement or to the following: *Name Address (Street-City-State-Zip) Telephone Number Relationship to child Relationship to Parent(s) or Guardian Other identifying information (if any) *Name Address (Street-City-State-Zip) Telephone Number Relationship to child Relationship to Parent(s) or Guardian Other identifying information (if any)
Persons to contact in the case of emergency when parent or guardian cannot be reached: Name Phone #(s) Name Phone #(s) Name Phone #(s) Name of Public or Private School child attends, if any: Child’s doctor or clinic name Doctor/clinic phone # My child has the following special needs PAGE 2 of 3 The following special accommodation(s) may be required to most effectively meet my child’s needs while at the center: My child is currently on medication(s) prescribed for long-term continuous use and/or has the following preexisting illness, allergies, or health concerns: EMERGENCY MEDICAL AUTHORIZATION Should (child’s name) Date of birth suffer an injury or illness while in the care of (Facility name) and the facility is unable to contact me (us) immediately, it shall be authorized to secure such medical attention and care for the child as may be necessary. I (We) shall assume responsibility for payment for services. Parent/Guardian: Date: Facility Administrator/Person-In-Charge Date: Signature Signature
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 and 10:
BRIGHT FROM THE START: GEORGIA DEPA
Page 11 and 12:
Exemptions Do you own any exempted
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 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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