Pennsylvania
Daycare forms PA: the official Pennsylvania child care forms, and where to download each PDF
Every numbered form on the DHS Child Care Forms index, grouped by what it does.
The GetDocsSigned Team · Last updated August 29, 2026
Pennsylvania daycare forms are the CD, CY and PW documents the Department of Human Services publishes for certified child care — the certification application, child health records, the day care agreement, staff health assessments and clearances, and the drill and incident logs. Anyone running a child care center, group child care home or family child care home in Pennsylvania needs them. All of them are free on pa.gov, and this page indexes them by number.
Not affiliated with the Commonwealth of Pennsylvania. GetDocsSigned is a private company with no affiliation with or endorsement from DHS or OCDEL. Official forms belong to DHS, are downloaded from pa.gov, and are submitted to the State through its own official channels — never through us.
What are Pennsylvania daycare forms?
They are the numbered forms DHS publishes for certified child care facilities, and the prefix tells you roughly where each one comes from — CD and CY forms come through the Office of Child Development and Early Learning, SP 4-164 is a Pennsylvania State Police form, and PW 29A is an enrollment and attendance record. Each one is free to download, and the copy on pa.gov is the only version your certification representative is guaranteed to accept. Third-party copies go stale when DHS revises a form, which it does on its own schedule.
Who certifies daycares in Pennsylvania — the state, a county, or a city?
The state, through five regional offices. Pennsylvania does not license child care the way you might expect from the word: DHS says a provider running a program for four or more unrelated children must be certified, and what you receive is a Certificate of Compliance, issued by OCDEL's Bureau of Certification Services. DHS then glosses it for you — each facility type “must have a certificate of compliance (‘license’) from DHS in order to legally operate.” OCDEL itself is a dual deputate of DHS and the Department of Education.
Which chapter of the regulations applies depends on the size and setting of your program: 55 Pa. Code Chapter 3270 covers child care centers, seven or more unrelated children; Chapter 3280 covers group child care homes, seven through 12 children of various ages, or seven through 15 from 4th grade through age 15; Chapter 3290 covers family child care homes, four, five or six unrelated children in a home. Chapter 20 sits above all three and governs applying for the certificate, inspections, and denial or revocation. DHS publishes all four.
Certification runs through the State even in Philadelphia — worth checking, because in some states the largest city permits its own centers. Five Regional Child Development Offices divide the Commonwealth by county, and Philadelphia is not carved out of that map: it sits inside the Southeast Region, split by ZIP code between that region's north and south county groupings. Your regional office is who you apply to, who inspects you, and who takes complaints.
Which forms do I need to open a daycare in Pennsylvania?
More than the ones below — so start here, but do not stop here. DHS publishes its own guidance on what a complete Certificate of Compliance application contains, and most of it is not a numbered form at all:
- The completed Application for Certificate of Compliance, CD 633 (55 Pa. Code §20.21)
- A certificate of occupancy showing the building complies with the Uniform Construction Code and is acceptable for use as a child care center, group child care home or family child care home
- Child Abuse History, State Police criminal history, FBI criminal history and National Sex Offender Registry clearances for the applicable people — plus out-of-state clearances for anyone who has lived outside Pennsylvania in the past five years
- A disclosure statement for each applicable person, signed, witnessed and dated
- A certificate of completion of mandated reporter training
- Business papers filed with the Pennsylvania Department of State, where applicable
The certificate of occupancy is the one that surprises people: it comes from your local code official under the Uniform Construction Code, not from DHS, so it is the one piece of the package that is genuinely local. Everything else routes through your Regional Child Development Office, which also runs the orientation session you must attend before a certificate is issued. The table below is the recurring paperwork — what a running program touches again and again.
Certification (getting and keeping the Certificate of Compliance)
What you file with your Regional Child Development Office to operate legally, and to vary a regulation.
| Form # | Title | Who completes it | Official form |
|---|---|---|---|
| CD 633CD 633 10/17 | Application for Certificate of Compliance: Center, Group, and Family HomePrinted on the form as “Application for Certificate of Compliance” | The individual or legal entity applying to operate the facility | Find “CD 633”Download it from the official DHS Child Care Forms index |
| CD 357CD 357 12/20 | Request For Waiver of Child Care Facility Regulation | Provider — filed under 55 Pa. Code §§3270.13, 3280.13 and 3290.25, relating to waivers | Find “CD 357”Download it from the official DHS Child Care Forms index |
Child health and medication
The health record every child needs on file, and the log for anything administered at the facility.
| Form # | Title | Who completes it | Official form |
|---|---|---|---|
| CD 51CD 51 09/08 | Child Health AssessmentPrinted on the form as “Child Health Report” | Parent or provider fills the first part and signs; a health professional verifies and completes the medical data (55 Pa. Code §§3270.131, 3280.131, 3290.131) | Find “CD 51”Download it from the official DHS Child Care Forms index |
| CY 862CY 862 10/04 | Medication Log | Provider, per child and per medication (55 Pa. Code §§3270.133, 3280.133, 3290.133) | Find “CY 862”Download it from the official DHS Child Care Forms index |
Enrollment and child records
The paperwork that repeats — collected from a parent at admission and kept in the child’s file.
| Form # | Title | Who completes it | Official form |
|---|---|---|---|
| CY 867CY 867 10/22 | Emergency Contact/Parental Consent Form | Parent or guardian — emergency contacts, persons the child may be released to, allergies, physician, insurance, and a separate signature for each consent | Find “CY 867”Download it from the official DHS Child Care Forms index |
| CY 321 | Day Care Agreement | Operator and parent both sign — 55 Pa. Code §3270.123 requires the agreement to specify fee, payment date, services, arrival and departure times, who the child may be released to, admission date and extras; the parent receives the original | Find “CY 321”Download it from the official DHS Child Care Forms index |
| CY 863 | Verbal Request for Release of Child | Provider, to document a parent’s verbal request to release a child to someone not named on the agreement (55 Pa. Code §§3270.117(c), 3280.117(c), 3290.116(c)) | Find “CY 863”Download it from the official DHS Child Care Forms index |
| CD 208CD 208 9/17 | Child Service Report | Provider — the Department’s form for reporting a child’s growth and development to the family, required as part of the services listed in the agreement | Find “CD 208”Download it from the official DHS Child Care Forms index |
| PW 29APW 0029A 2/08 | Day Care Services Enrollment/Attendance Record | Provider — monthly enrollment and daily attendance | Find “PW 29A”Download it from the official DHS Child Care Forms index |
Staff health, hiring and clearances
Screening and health paperwork for anyone employed, volunteering or living where care is provided.
| Form # | Title | Who completes it | Official form |
|---|---|---|---|
| CD 322CD 322 2/12 | Child Care Staff Health Assessment | Employer completes the job-activities section; a physician, physician’s assistant or CRNP completes the examination. Printed reasons for examination: initial employment in child care, or biennial re-examination (55 Pa. Code §§3270.151, 3280.151, 3290.151) | Find “CD 322”Download it from the official DHS Child Care Forms index |
| CY 142CY 142 6/18 | Child Care Employee Data Sheet | The employee — education, employment history and facility details | Find “CY 142”Download it from the official DHS Child Care Forms index |
| — | Child Care Employment Verification Form | The applicant authorises release; a former employer supplies the job history | Find on the indexDownload it from the official DHS Child Care Forms index |
| —01/01/25 | Disclosure Statement for Child Care EmploymentPrinted on the form as “Disclosure Statement — Application for Child Care Employment, Including Provisional Employment” | The applicant, signed, witnessed and dated — required by the Child Protective Services Law, 23 Pa.C.S. §6344 | Find on the indexDownload it from the official DHS Child Care Forms index |
| —11/08/2024 | Disclosure Statement for Child Care VolunteersPrinted on the form as “Disclosure Statement — Application for Child Care Volunteer Position” | The volunteer applicant — required by 23 Pa.C.S. §6344.2 | Find on the indexDownload it from the official DHS Child Care Forms index |
| CY 113CY 113 12/15 | Pennsylvania Child Abuse History Clearance | The applicant, submitted to ChildLine | Find “CY 113”Download it from the official DHS Child Care Forms index |
| CY999CY 999 3/16 | Consent/Release of Information Authorization Form | The applicant, authorising ChildLine to release the Child Abuse History Certification | Find “CY999”Download it from the official DHS Child Care Forms index |
| SP 4-164SP 4-164 (10-2025) | Request for Criminal Record Check | The requester, in ink — Pennsylvania State Police form, hosted on epatch.pa.gov rather than on the DHS index | Find “SP 4-164”Download it from the official DHS Child Care Forms index |
Safety, emergency and incident records
Drills, emergency planning, and what you file when something happens.
| Form # | Title | Who completes it | Official form |
|---|---|---|---|
| CY 866 | Incident Report Form | The staff person who prepared it signs and dates it (55 Pa. Code §3270.20(d)); the original goes to the parent on the day of the incident, with copies kept in the accident file and the child’s file (§3270.182(7)) | Find “CY 866”Download it from the official DHS Child Care Forms index |
| CD 355CD 355 11/20 | Documentation of Emergency Plan Delivery | Provider — evidence the emergency plan and every update went to the local and county municipalities (55 Pa. Code §§3270.27(f), 3280.26(f), 3290.24(f)) | Find “CD 355”Download it from the official DHS Child Care Forms index |
| CD 356CD 356 12/20 | Emergency Drill Log | Provider — date and time of each drill, kept at the facility (55 Pa. Code §§3270.27, 3280.26, 3290.24) | Find “CD 356”Download it from the official DHS Child Care Forms index |
| CY 864Updated 4/8/2021 | Fire Drill LogPrinted on the form as “Fire Drill and Fire Detection Log” | Provider (55 Pa. Code §§3270.94/.95, 3280.94/.95, 3290.94/.95) | Find “CY 864”Download it from the official DHS Child Care Forms index |
Where a form prints its own number-and-date line, that line is reproduced verbatim under the form number. It is not always the number the index uses — PW 29A prints itself as “PW 0029A” — and a blank means the PDF prints none, not that the form has never been revised.
Where do I download PA daycare forms as PDFs?
From the DHS Child Care Forms index on pa.gov, which publishes every one of them as a free PDF — that is the authoritative source, and the links in the table above point to it rather than to copies hosted here. We deliberately do not deep-link the individual PDFs: DHS re-issues them on revision and shuffles them between directories, so a saved link turns into a 404 without warning.
Open the official DHS Child Care Forms indexWhich forms do parents fill out vs. the provider?
The provider files the certification paperwork with the State; parents complete the enrollment paperwork and hand it back to you. That split matters, because the two halves have completely different lifecycles — you file a CD 633 once and renew on a cycle, but you collect a health report, emergency contacts and a signed agreement from every new family, forever. Pennsylvania is unusually explicit about what that second half contains. 55 Pa. Code §3270.182 lists what a child's record must hold:
- Initial and subsequent health reports
- The dates of application, admission and withdrawal of the child
- Signed parental consent for emergency medical care, in writing before admission
- Signed parental consent for administration of medications or special dietary needs
- Signed parental consent for minor first-aid procedures by staff, in writing before admission
- Signed parental consent for transportation, walking excursions, swimming and wading
- Reports of accidents, injuries and illnesses involving a child in care
- A copy of the initial and any subsequent written agreements between the parent and the operator
In practice that is CD 51 for the health report, CY 867 for the emergency contacts and each separate consent signature, and CY 321 for the agreement — which §3270.123 requires the operator and the parent to sign, with the original going to the parent.
The certification half stays exactly where it is: DHS forms, downloaded from pa.gov, submitted through your Regional Child Development Office. Nothing about that changes and nothing about it runs through us.
The parent-facing half is the part that repeats, and that is the part we handle — one link families complete on a phone, covering child information, emergency contacts, authorized pickup, immunization records, allergies and consents, with a checklist per child showing what is still missing.
Common questions
Does Pennsylvania license or certify a daycare?
Certify — though DHS uses both words. Pennsylvania calls the process certification, the document is a Certificate of Compliance, and the office that issues it is OCDEL’s Bureau of Certification Services. DHS then glosses it for you: on its own provider page each facility type “must have a certificate of compliance (“license”) from DHS in order to legally operate.” Anyone running a program for four or more unrelated children must be certified.
What is the child care staff health assessment form in Pennsylvania?
CD 322, the Child Care Staff Health Assessment, published on the DHS Child Care Forms index and required under 55 Pa. Code §§3270.151, 3280.151 and 3290.151. It comes in two halves: the employer describes the job activities — lifting and carrying children, close interaction, food preparation, driving, facility maintenance, desk work — and a physician, physician’s assistant or certified registered nurse practitioner completes the examination. The form itself prints two reasons for examination: initial employment in child care, and biennial re-examination.
Is GetDocsSigned affiliated with Pennsylvania DHS or OCDEL?
No. We are a private company with no affiliation with, endorsement from, or connection to the Pennsylvania Department of Human Services or the Office of Child Development and Early Learning. Every official form listed on this page belongs to DHS and is downloaded from pa.gov. We list them because providers ask where they are, not because we have any role in them.
Can I submit Pennsylvania child care forms to the state through GetDocsSigned?
No, and you should be careful of any vendor who says otherwise. Certification paperwork goes to DHS through the State’s own channels — your Regional Child Development Office and the instructions printed on each form. We never transmit anything to DHS on your behalf.
Do I still need paper copies if I collect the packet online?
Possibly, and the retention rule is the part to check first. 55 Pa. Code §3270.185 says a copy of the child’s record must be kept at the facility for at least a year after service ends, unless the whole record is transferred to the parent or another agency at the parent’s request. The regulation sets the period, not the medium, so confirm with your Regional Child Development Office before you retire any paper file, and treat anything collected online as an addition until you have.
What if a form number on this page is out of date?
Always download the form itself from the DHS Child Care Forms index rather than from any third-party copy, including ours. DHS revises these forms and moves the PDFs between directories on its own schedule, and a file saved from a blog post a year ago may not be the version your certification representative accepts. This page carries a visible last-updated date so you can see how fresh it is.
Collect the parent paperwork online
Your DHS certification forms stay with the State. The half §3270.182 puts in every child's file — health report, emergency contacts, consents, the signed agreement — can be one link on a parent's phone instead of a folder on your desk.
Use the enrollment packet — freeNo credit card. Free plan: 2 live forms, 25 responses a month, 2 child record folders, unlimited staff. Paid plans from $9.99/month.
Informational only, and not legal advice. GetDocsSigned is not affiliated with, endorsed by, or connected to the Pennsylvania Department of Human Services or the Office of Child Development and Early Learning. Form numbers and requirements change — confirm everything against the DHS Child Care Forms index before you file. This page indexes 5 groups of forms from that index and is not the complete Certificate of Compliance application package.