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Home Daycare Registration and Renewal Application

Steps

  1. 1. Step One
  2. 2. Step Two

  • Step One

    2. Type of Application*
    6. Over 18 Years Old?*
    10. Over 18 Years Old?
    18. Do You Have CPR Certification?*

      If yes, please attach a copy of your certification. 

    21. Check if any Apply to You?

      If yes, attach a copy of your state issued document.

    24. FACILITY SKETCH

      Applicants are required to provide a sketch of the floor plan of the home or facility and outside yard. 

      The floor sketch must label rooms such as the kitchen, bath, living room, etc. Please identify areas which will be "off limits" to children. Door and window exits from the rooms must be shown in case of an emergency. Show room sizes (e.g. 8.5 x 12). Keep close to scale. 

      The yard sketch should show all buildings in the yard including the home (with no detail), garage and storage buildings. Include walks, driveways, play area, fensces, gates. Please identify areas which will be "off limits" to children. Show any potential hazardous areas such as pools, garbage storage, animal pens, etc. Show the overall yard size. Try to keep the sizes close to scale. 

      You can use the blank grid paper below, complete sketch, and then upload your document. If you prefer, you can mail your sketch to Fire EMS Department, 25 Center St. Vermillion, SD. 57069. The sketch must be received before your inspection. Make sure to indicate the name and address of your daycare on the sheet. 

    26. Blank Grid Paper for Facility Sketch
    30. Electronic Signature Agreement*

      By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, in both areas below,  you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    32. I/We certify that:

      1.  I/We live in the home to be licensed.
      2.  I/We have both a Fire Marshal approved fire extinguisher and a smoke detector in operating condition.
      3. I/We have a playground area enclosed by a barrier (fence, hedge, trellis, or other barrier) not less than 42 inches high or signature from each child's parent or guardian being cared for stating they understand there is not an enclosed playground area at the registered location. 

    34. I/We declare under penalty of perjury that the statements on this application and accompanying attachments are correct to the best of my/our knowledge. 

    36. Pre-Registration Readiness Guide
      Pre-Registration Readiness Guide

      Use this checklist to prepare for your home inspection. 

    37. Emergency Disaster Plan for Family Child Homes
      Emergency Disaster Plan

      Complete this form and place near the phone or another prominent location in the home.