Child Care Licensing Forms

Child Care Licensing Backgrounds

Child Care Licensing (CCL) requires background checks to be completed by every employee, resident, and/or volunteer of a child care facility at least every five years to ensure the safety and well-being of children served in licensed child care facilities, per NRS 432A.175. Background checks will include a local criminal check, a local/national sex offender registry check, and a local/national child abuse and neglect check. If a background applicant has not resided in the State of Nevada in the last five years, a background check is required from the state the applicant is coming from.

Nevada does not participate in the National Fingerprint File program. Nevada is a Privacy Compact State. 

For any questions regarding background investigations, contact the Background Unit at dpbhcclbackgrounds@health.nv.gov or call 702-486-3822 (Las Vegas) or 775-684-8781 (Carson City).

Contact Child Care Licensing

3811 W. Charleston Blvd. #210

Las Vegas, NV, 89102

P: 702-486-3822

F: 702-486-6660

• Fingerprinting Instructions
  • More information on obtaining fingerprints
• Background Check Consent and Release
• List of Disqualifying Crimes
• Scope, Severity and Sanction Matrix

Survey Checklists

To ensure compliance with the most recent requirements, download these blank checklists for the Initial Survey, Annual Survey, and Semi-Annual Survey. These checklists have been revised of September 2024.

• Annual Survey
• Initial Survey
• Semi-Annual Survey

Forms - License Renewal

These forms are required for your renewal application. They should be completed and attached to your online renewal application in the checklist section.

• Center-Group-Family Listings of Trainings
• Institution Listing of Trainings
• Listing of Employees/Residents

Sample Forms - Facility Logs

Listed below are samples of logs needed in the ongoing operation of a licensed Nevada child care facility. They may be used as posted here or you can create your own versions.

• Child care facility driver form
• Fire/Disaster Drill
• Substantiated Complaints Log (Parent Form)
• Transportation Log
• Carpet Cleaning Log

Sample Forms - Daily Operations

Listed below are samples of forms needed in the day-to-day operation of a licensed Nevada child care facility. They may be used as posted here or you can create your own versions.

• Abuse and Neglect Reporting Form
• Accident/Incident Form
• Child Record Form
• Employee Training Form
• Phone Emergency List Form
• Facility Right to View Complaints Statement
• Field Trip Permit Form
• Health Statement
• Infant Daily Report
• Medication Request Form
• Permission to Release Information Form
• Sign In/Out Form