Permit Checklist


1: Complete the Home Child Care Facility Application (English) or (Spanish)

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Complete all the requested information, and send this form to the Office for Children with the other two forms below. Include payment for the $14 application fee. You can pay by personal check, certified check, or money order. Make it payable to the Office for Children. This $14 fee is non-refundable. There is a $50.00 fee for any check returned for insufficient funds.

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When you are asked to write names, write full names and not just initials. Write N/A for "not applicable" if a person listed does not have a middle name or a maiden name.

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Section B: Make sure you have listed all children who are age 13 or younger who live in your home.

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Section C: List yourself, and any other adults, and children who are age 14 or older who may regularly be in your home while you are caring for children.

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Section D: List yourself and anyone age 18 or older who may regularly be in your home while you are caring for children. Include a payment of $15 for each person you list for the criminal history record request. You can pay by personal check, certified check, or money order. Make it payable to the Office for Children. This fee is non-refundable. There is a $50.00 fee for any check returned for insufficient funds.

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Make sure to sign the application.

2: Complete the Central Registry Release of Information Form (English) or (Spanish)

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Only two-sided forms may be submitted. This form may not be faxed in; you must mail it or take it to the Office for Children.

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Complete a separate form for yourself and each person age 14 or older who lives in your home. Write full names and not just initials. Write N/A for "not applicable" if a person you list does not have a middle name or maiden name.

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Forms for children age 14-17 require a parent's signature.

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This form must be notarized on the back by a notary public, with the notary number and commission expiration date.

3: Complete the Sworn Statement/Affirmation Form (English) or (Spanish)

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Complete a separate form for yourself and each person age 18 or older who lives in your home. Write full names and not just initials. Write N/A for "not applicable" if a person you list does not have a middle name or maiden name.

Mail all three completed forms with the required payment to:

Fairfax County Office for Children
Community Education and Provider Services
12011 Government Center Parkway, Suite 800
Fairfax, VA 22035-1102

Finally: Comply with these Additional Permit Requirements.

 

Go back to: Apply for a Family Child Care Permit

 


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