Quality Assurance Division

Child Care Licensing

Change of Name / Address / Ages of Application

The following forms / information are included in an Address Change Application for Family, Group, and Center Facilities:

• Name/ Address/ Ages Change Checklist (Print First)
• Name/ Address/ Ages Change Application
• Fire Safety and Evacuation Plan
• Insurance Verification Form
• Floor Plan/ Square Footage Report

All Change of Name/ Address/ Ages Application Packets need to be submitted the local Child Care Licensor