Below are a series of sample forms and documents that will make it easier to comply with the requirements of the rules for operating a program, enrolling children, and employing child care staff. The last section contains helpful information regarding such topics as immunization, weather conditions, and illnesses; it also contains resources that may be helpful in providing quality child care, including contacts with other agencies and services in the state if Maine or on the national level.
Disclaimer: The forms and documents made available on this site will meet the minimum requirements established in rule, if they are adopted as drafted. Providers may choose to expand the content to meet the needs of their services and are encouraged to personalize them by adding program names, logos, and/or policies and procedures. Otherwise deleting and/or altering the content of these forms may have the result that they are no longer compliant with the rules.
Sample Program Forms
- Daily Attendance Form (PDF) (also available in Word)
- Sample Employee Handbook Outline (PDF) (also available in Word)
- Fire Drill Log (PDF) (also available in Word)
- Sample Health Care Consultant Agreement (PDF) (also available in Word)
- Sample Parent Handbook Outline (PDF) (also available in Word)
- Play Area Inspection Form (PDF) (also available in Word)
- Sample Swimming Pool Safety Rules (PDF) (also available in Word)
- Waiver Request Form (PDF) (also available in Word)
- Weekly Attendance Record (PDF) (also available in Word)
- YIKES Planning Guide 2015 (PDF) (also available in Word)
- YIKES Emergency Response Plan (PDF) (also available in Word)
Sample Parent/Child Record Forms
- Sample Child Care Contract (PDF) (also available in Word)
- Sample Child Record Contents (PDF) (also available in Word)
- Child Record Cover Sheet (PDF) (also available in Word)
- Emergency Medical Treatment Release (PDF) (also available in Word)
- Serious Injury/Illness Report (Word)
- Medication Administration Record (PDF) (also available in Word)
- Notifiable Conditions Reporting Form (PDF) (also available in Word)
- Permission Form (PDF) (also available in Word)
- Mandated Reporter Worksheet (PDF) (also available in Word)
Sample Employee Record Forms
- Nursery School Medical Statement (PDF) (also available in Word)
- Orientation Checklist for Child Care Centers (PDF) (also available in Word)
- Personnel Evaluation Form (PDF) (also available in Word)
- Personnel File Contents (PDF) (also available in Word)
- Sample Training Log (PDF) (also available in Word)
Information and Resources
- Information on the Child Care Background Check Process
- Maine Roads to Quality Professional Development Network for Child Care Providers (PDF) (providing technical assistance and training to providers)
- Pool Matrix (PDF) (also available in Word)
- CDC Immunization Schedule 2020 (PDF)
- Useful Internet Links (PDF)
- Commonly Used Terms (PDF)
- Contact List (PDF)
- FAQs (PDF)
- Lead Safe Child Care (PDF)
- Notifiable Conditions List: Illnesses that must be reported to the Maine CDC (PDF)
- WeatherWatch (PDF)