Licensing Application Information and Forms
The Application Process for Operational Licensure
Organizational Structure of the Pacific Union Conference Office of Education Early Childhood Education and Care Division (PPGM Code Items 5108-5116, 5132)
Pacific Union Conference Office of Education
The Pacific Union Conference Office of Education (PUCOE) is an administrative office operating within a structure authorized by the Pacific Union Conference Executive Committee.
Pacific Union Conference Board of Education
The Pacific Union Conference Board of Education (PUCBOE) is the policy formulating body of the K-12 school system. It derives its authority from the Pacific Union Conference Executive Committee. The PUCBOE does not formulate Early Childhood Education and Care (ECEC) policies, procedures or guidelines. ECEC facilities are not restricted to or by the PUC Education Code.
Pacific Union Conference Office of Education, Early Childhood Education and Care Division
The Pacific Union Conference Office of Education, Early Childhood Education and Care Division facilitates the establishment of standards and policies for the operation of high quality early childhood education and care programs for children from birth through preschool that are consistent with the Seventh-day Adventist philosophy of education.
The ECEC Division establishes and organizes a union-wide Early Childhood Education and Care Advisory and an ECEC Board.
The ECEC Advisory and Board are the policy, procedure and guideline formulating bodies of the ECEC system. It derives its authority from the Pacific Union Conference Executive Committee. The ECEC Advisory and Board are independent of the PUCBOE and provide guidance on policies, standards, and practice, legislative updates, field notes and pertinent information.
Definition of an ECEC Center
A Seventh-day Adventist Early Childhood Education and Care center is a purposefully organized entity hosted by a Seventh-day Adventist church or school and providing for the educational and custodial needs of young children who may range in age from birth through preschool, and before they enter formal elementary school, under the direction of trained personnel, and in accordance with PUCOE, ECEC policies, procedures, guidelines and relevant state regulations. In addition, it may include programs for kindergarten and extended care for school age children. It is a component of the educational system of the Pacific Union Conference.
Application for Operational Licensure
To provide a consistent organizational structure, the PUC ECEC Board has resolved that all proposed early childhood programs within the Pacific Union Conference must file an application for operational licensure with the Pacific Union Conference Office of Education, Early Childhood Education and Care Division, regardless of any applicable state licensing exemptions (Bylaws of the Pacific Union Conference of Seventh-day Adventists, Article VIII, Section 3; Pacific Union Conference Early Childhood Education and Care Policy, Procedure and Guidelines Manual, PPGM1, Administrative Guidelines Introduction).
In order to operate a classroom or facility defined as an ECEC center above, an operational license must be applied for under the name of the organization that is legally responsible for operating the center. Within the Pacific Union Conference, the legally responsible organization is the local conference office association. Each conference association’s board has an authorized liaison who meets the requirements for operational licensure application submissions. (Licensing application forms can be found on the PUC Office of Education website at: http://paucearlychildhood.adventistfaith.org/.)
The chief executive officer of the association (Conference President) has an authorized liaison from within the Conference Office of Education staff. This individual is responsible for assisting with and signing all application forms. The liaison also provides oversight of the facility’s strategic planning, licensing forms, and content of supportive documents as set forth by the state and the Pacific Union Conference Early Childhood Education and Care Policy, Procedure and Guidelines Manual (PPGM).
The anticipated facility administrator/director will be required to submit their fingerprints to the licensing office, complete a health screening and licensure orientation in order to be able to complete the child care application process. Prior to meeting these requirements, the local preschool board and conference-authorized liaison must confirm that the anticipated facility administrator/ director fulfills the experience and educational requirements mandated by the state and PPGM. Once it has been determined the requirements have been met, the anticipated facility administrator/ director would then be responsible for providing all the additional information required by the licensing department prior to licensure.
In an effort to help demonstrate the suggested division of responsibilities of the conference-authorized liaison and the anticipated facility administrator/director, please see the Division of Responsibilities page.
When applying for a license, the applicant will be required to complete an application packet of information. Each state’s requirements will be somewhat different, but a typical packet will include the following:
- Application and fee schedule
- Local fire inspection form and fee schedule
- Local health department facility inspection form and fee schedule
- Tuberculosis test for all adults to be employed at the center, and/or a completed medical examination form/health information sheet signed and dated by a licensed doctor or nurse
- Criminal Record Statement/background check/fingerprint form/Livescan sheet/Felony Statement
- Emergency care and disaster plan form
- Facility and playground sketches with emergency exits clearly marked
- Business plan and intended operational methods
- Articles of Incorporation, Constitution, By-laws, and relevant board resolutions
- Proof of current CPR/First Aid training
- Orientation certificate(s)
- Annual in-service training topic outline
- Educational background/resume/transcripts
- Sample Parent Handbook and Policies
- Sample Employee Handbook and Policies
- Discipline Policy
- Staffing organizational plan and assignments
- Daily schedule for each age group served
- Sample menus
- Sample lesson plan and curriculum outline
Reminder:
It is the applicants’ responsibility to be in compliance with all city, county, and other state, or federal laws. Before an application for child care operation is submitted, be sure to confirm:
1. Tax Codes
2. Labor Codes
3. Zoning/Building, Fire and Safety Codes
4. Workers Compensation Requirements
5. State OSHA Requirements
6. Health Department Codes
7. Americans with Disabilities Act (ADA)
8. Immigration and Naturalization Laws
9. Discrimination Laws
10. Local Business Laws
It will also be helpful to be in contact with a local Child Care Advocate and Public Counsel Office. Both of these can be found through a local Resource and Referral Agency.
Upon Union and Conference approval of the licensure application, state licensing regulations regarding the proposed early childhood facility will be reviewed and adhered to. This review will also involve the procurement of relevant association board actions prior to the submission of a state licensure application.
Once the facility has been granted a license for operation, the conference-authorized liaison from within the Office of Education will then complete and sign a Designation of Facility Responsibility. This will identify the director as the person authorized to act in the licensee’s absence to receive any documents including reports of inspections and consultations, accusations and civil and administrative processes at the facility.
Maintain copies of everything sent to the Union, Conference and licensing offices. Also, keep track of the name(s), phone numbers, and dates on which communications took place and what they entailed. Diligence in these areas will help to lesson the likelihood of problems and misunderstandings later in the process.
For additional information, please contact the Early Childhood Education and Care Division Coordinator for the Pacific Union Conference of Seventh-day Adventists Office of Education.
- Administrative Organization Form 309
- Applicant Information Form 215
- Application for Child Care Center License Form 200A
- Balance Sheet Form 403
- Balance Sheet - SupplementalSchedule Form 403A
- Criminal Record Statement Form Form 508
- Designation of Facility Responsibility - Conference Liaison & Director/Administrator Forms 308A & 308B
- Division of Responsibilities
- Earthquake Preparedness Checklist Form 9148
- Emergency Disaster Plan Form 610
- Employment Application
- Facility Sketch (Floor Plan) Form 999
- Financial Information Release and Verification Form 404
- Health Screening Report - Facility Personnel Form 503
- Local Fire Inspection Authority Information Form 9054
- Minimum Wage by State website
- Monthly Operating Statement Form 401
- Monthly Operating Statement-Supplemental Schedule Form 401A
- Personnel Report Form 500
- Personnel Record Form 501