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DEPARTMENT OF CHILDREN AND FAMILIES
Division of Early Care and Education
STAFF RECORD CHECKLIST – FAMILY CHILD CARE CENTERS
CONFIDENTIAL – DO NOT POST
dcf.wisconsin.gov
1
Use of form: Use of this form is voluntary. It is intended for use as a review document for all staff records by child care centers and licensing specialists. Completion of
this form by licensees will help ensure compliance with DCF 250.05(2). Personal information you provide may be used for secondary purposes [Privacy Law,
s.15.04(1)(m), Wisconsin Statutes].
Instructions: A separate file is required for each provider, employee, or substitute. A check mark or date indicates that the required information is in the staff file. Name,
employment date, and position title should be filled in. Do not post this form in the center.
Child Care Center Name
Address (Street, City, Zip)
Facility ID Number
Provider / Staff Name
and Position Title
Start Date
(mm/dd/yyyy)
Staff Record
–
Child Care Centers
250.05(2)(a)
Preliminary Eligibility / Determination
from CBU
Final Eligibility / Determination from
CBU
Staff Health Report
-Physical Ability
250.05(2)(d)1.b.
Staff Health Report
-Free from Illness
250.05(2)(d)1.a..
SBS / AHT prevention training
250.05(3)(g)
Registry Certificate 250.05(2)(e)
Entry
-
level training
250.05(
3)(b)
Current infant / child CPR certificate
250.05(3)(e)
Biennial CAN training
250.04(8)(b)
Continuing education
250.05(3)(c)1.
10 hour I/T training
250.05(3)(f).
Documentation of actual hours worked
250.05(2)(c).
Driving record, if transporting children
250.08(4)(c)
Annual driver training 250.08(4)(b)
A.
B.
C.
D.
E.
F.
G.
The department-approved courses
Introduction to the Child Care Profession
and
Fundamentals of Family Child Care
are the non-credit courses that meet the entry-level
training requirement.
Introduction to the Child Care Profession
and
Fundamentals of Infant and Toddler Care
taken after 09/02/2001 contain the SIDS risk reduction
component, and courses taken after 07/01/2005 contain the SBS / AHT training component.
Health, Safety, and Nutrition
courses taken from a technical college after
01/01/2006 contain the SBS / AHT training component.
DCF-F-CFS2051-E (R. 09/2021)
DEPARTMENT OF CHILDREN AND FAMILIES
Division of Early Care and Education
STAFF RECORD CHECKLIST – FAMILY CHILD CARE CENTERS
CONFIDENTIAL – DO NOT POST
dcf.wisconsin.gov
DCF-F-CFS2051-E (R. 09/2021) 2
Child Care Center Name
Facility ID Number
STAFF FILE
/
FORM
BCR
/
CBC
PHYSICAL
QUALIFICATIONS
CONTINUING ED
CAN TRAINING
SBS
/
AHT TRAINING
ORIENTATION
CPR
LICENSEE
1
YES
2
YES
YES
YES
YES
YES
6
YES
NO
8
YES
CHILD CARE PROVIDER
/
EMPLOYEE
YES
YES
YES
4
YES
YES
YES
6
YES
YES
8
YES
SUBSTITUTE
YES
YES
YES
5
YES
YES
YES
6
YES
YES
5
YES
VOLUNTEER USED TO MEET RATIOS
YES
YES
YES
5
YES
NO
YES
6
YES
YES
5
YES
VOLUNTEER NOT USED TO MEET RATIOS
NO
3
NO
NO
NO
NO
NO
NO
YES
NO
EMERGENCY BACK
-
UP PROVIDER
NO
3
NO
NO
NO
NO
NO
6
YES
7
YES
NO
1 – If the licensee is a provider, a staff file is required. 2 – On file with DCF. 3 – BCR recommended. 4 – Second providers required to meet staff-to-child ratios have six
months after beginning work to complete the required training. 5 – After 240 hours. 6 – All persons who provide care and supervision to children under age five.
7 – Does not have to be written. 8 – Within three months of licensure or date of hire.
Notes:
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Completed 29 October 2021

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