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The Official Website of the Executive Office of Education (EDU)
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  1. Home
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  3. Early Education & Care
  4. Provider and Program Administration
  5. Forms for Program Administration
  6. Early Education and Care Program Forms
  7. Forms for Group Child Care & School Age Programs
  8. GCC & SA Lic Forms

Required Group Child Care & School Age Program Licensing Forms

  • Change in Licensed Capacity Application pdf format of 			Change in Licensed Capacity Application

    This form is must be signed and completed when a Large Group Child and /or School Age program changes their licensed capacity. Word Document doc format of    gccsaccchancap.doc
  • Children's Records Checklist and Instructions pdf format of 			Children's Records Checklist and Instructions

    Use this checklist to keep track of the children's records for documentation purposes. Word Document doc format of    gccsaccchldrecch.doc
  • Family Involvement Information pdf format of 			Family Involvement Information

    This document describes requirements of child care programs and providers in regard to working with families and parents. Word Document doc format of    family_involve_info.doc
  • Fee Schedule pdf format of 			Fee Schedule

    This schedule identifies licensing application fees for all childcare programs.
  • Health Care Consultant Agreement pdf format of 			Health Care Consultant Agreement

    The Department of Early Education and Care Standards for the Licensure or Approval of Group Child Care and School Age Child Care Programs, 102 CMR 7.00, require that each licensee designate a Massachusetts licensed physician, registered nurse, nurse practitioner or physician's assistant, with pediatric or family health training and/or experience as the program's Health Care Consultant. Word Document doc format of    healthcareconagrement.doc
  • Indoor/Outdoor Space Sketch pdf format of 			Indoor/Outdoor Space Sketch

    This form is used by Group and School Age providers to describe their indoor and outdoor space. Word Document doc format of    in_outdoorspace.doc
  • Licensing Exemption Application links to PDF file

    In Massachusetts, a license is required to provide most child care services. In some circumstances, the caring arrangement may be exempt from licensure and may not require a license. Please complete this form to assist us in determining whether or not your program is exempt from child care licensing regulations. DOC
  • Required Documents for Provisional Licensure links to PDF file

    This form identifies all the written documentation necessary for the provisional licensing of a Small Group, Large Group and/or School Age program. DOC

  • Renewal Documents Verification Statement links to PDF file

    This form identifies all written documentation necessary for the renewal of a Small Group, Large Group and/or School Age license. DOC
  • Small Group, Large Group, and School Age Licensing Application links to PDF file

    This form must be completed when applying for a Small Group, Large Group or School Age Child Care License. DOC
  • Staff Information Form pdf format of 			Staff Information Form

    This form must be completed by all staff employed at the child care facility. Word Document doc format of    staffinformation.doc
  • Staff Records Checklist and Instructions links to PDF file

    This checklist completed by programs identifies all the information required in Small Group, Large Group and School Age Child Care staff files. Word Document  DOC

  • Tax Certification Statement pdf format of 			Tax Certification Statement

    This form verifies that your child care program has complied with state tax law. Word Document doc format of    taxcertstatement.doc
  • Transportation Supplement pdf format of 			Transportation Supplement

    This form must be completed for each vehicle used to transport children. Word Document doc format of    transportsuppl.doc
  • Variance request form pdf format of 			Variance request form

    Please complete this form and attach any additional information and return to your licensor. In order to receive a variance, you must submit clear evidence, to the satisfaction of the Department, that your variance proposal meets the spirit and intent of EEC regulations.

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