Washington County Forms

2. Name*
4. Address 1*
5. Address 2
7. City*
8. State*
9. Zip*
11. Email Address*
12. Phone Number*
16. How did you hear about Family Child Care Licensing?*
18. 1. How often does best practice recommend that a provider check on a newly enrolled, sleeping infant?*

    1. A. Every 5 minutes
    2. B. Every 15 minutes

    1. C. Every 30 minutes
    2. D. When it is time for the infant to wake up
20. 2. Your policies may be in any preferred format but they must include all required details.*

    1. True

    1. False
22. 3. Safe sleep for infants in child care allows for what object to be in a crib with an infant?*

    1. A. Bumper pad
    2. B. Pillow

    1. C. Blanket
    2. D. Pacifier with no attachments
24. 4. You must maintain all required forms and records for all enrolled children in your program and make them available for your licensor's review at any type of visit.*

    1. True

    1. False
26. 5. What is the maximum temperature of water in sinks and tubs accessible to children?*

    1. A. 120 degrees

    1. B. 100 degrees

    1. C. 130 degrees

    1. D. No maximum
28. 6. Which pets are allowed in the home of a family child care?*

    Check all that apply.

    1. A. Cats

    1. B. Dogs

    1. C. Rats

    1. D. Turtles
30. 7. Each family child care provider must have a written emergency preparedness plan for emergencies that require evacuation, shelter, or other protection of children.*

    1. True

    1. False
32. 8. How often must fire and storm drills be completed and documented for a licensed family child care provider?*

    1. A. Weekly

    1. B. Monthly

    1. C. Every 6 months

    1. D. Yearly
34. 9. Your own children, younger than 11, do not count towards your capacity.*

    1. True

    1. False
36. 10. A substitute in a family child care home is limited to a cumulative total of not more than how many hours annually?*

    1. A. 150 hours

    1. B. 500 hours

    1. C. 1,000 hours

    1. D. 2,080 hours
38. 11. Your licensor may inspect all areas of your home/property, whether used for child care or not.*

    1. True

    1. False
40. 12. Which requirements must a substitute fulfill prior to providing care?*

    1. A. Review program policies and procedures
    2. B. Complete a background study
    3. C. Submit a physician's statement of ability to provide care
    4. D. Take required training
    5. E. All of the above
42. 13. My licensing worker is here to help me. I should contact them for assistance with the requirements of a substitute caregiver before allowing the substitute to provide care.*

    1. True

    1. False
44. 14. Supervision means a caregiver being within sight or hearing of any infant, toddler, or preschooler at all times so the caregiver is capable of intervening to protect the health and safety of the child.*

    1. True

    1. False
46. 15. The minimum equipment needed for an infant is a crib, portable crib, or playpen.*

    1. True

    1. False
48. 16. Where should you send your license application form?*

    1. A. The Department of Human Services
    2. B. Your County Licensing Agency

    1. C. The Department of Labor & Industry
    2. D. Your County Public Health Department
50. 17. A background study must be completed prior to an individual residing in your home.*

    1. True

    1. False
52. 18. If you do not demonstrate compliance with all applicable licensing rules and statutes during your annual visit, which of the following actions may be taken by your licensor?*

    1. A. Technical assistance provided
    2. B. Fix-It Ticket issued
    3. C. Correction Order issued
    4. D. Licensing action, including Fine, Conditional License, Temporary Immediate Suspension
    5. D. Any of the above
54. 19. What are the things that licensors monitor in licensed family child care?*

    1. A. Training
    2. B. Health, Safety, & Ratios
    3. C. Background Studies
    4. D. Physical/Facility Standards
    5. E. All of the above
56. 20. You will need to take 18 hours of training every year.*

    1. True

    1. False
58. 21. If you are planning on having five child care children and two of your own children, how much usable indoor space is required to get licensed?*

    1. A. 700 square feet

    1. B. 245 square feet

    1. C. 500 square feet

    1. D. 950 square feet
60. 22. A newborn is birth to 8 weeks old.*

    1. True

    1. False
62. 23. What items are required to have in your home to become licensed?*

    1. A. Gates
    2. B. Carbon Monoxide Detectors

    1. C. Fence
    2. D. Cabinet Locks
64. 24. You need to take CPR and Pediatric First Aid every two years.*

    1. True

    1. False
66. 25. What possible items would need to be inspected prior to licensing?*

    1. A. Furnace and water heater
    2. B. Storage of chemicals
    3. C. Play area for animal feces
    4. D. Inside garbage/trash
    5. E. All of the above
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