Nebraska Childcare Required Forms & Documents (2026)

Nebraska childcare centers are required to collect and maintain a completed Complete, accurate, written and signed application and disclosure of ownership on a form provided by the Department (DHHS Application for Child Care Center license) - 391 NAC 3-003.01A(1) for every enrolled child (per Nebraska Department of Health and Human Services (DHHS), Division of Public Health, Licensure Unit - Children's Services Licensing (Child Care Centers)).

Nebraska childcare centers are required to collect and maintain a completed U.S. citizen / qualified alien attestation (Neb. Rev. Stat. ss 4-108 to 4-114) - 391 NAC 3-003.01A(2) for every enrolled child (per Nebraska Department of Health and Human Services (DHHS), Division of Public Health, Licensure Unit - Children's Services Licensing (Child Care Centers)).

Nebraska childcare centers are required to collect and maintain a completed Consent for Central Registry Checks and Authorization for Release of Information (applicant, all staff/volunteers age 13+, household members age 13+ if home-based) - 391 NAC 3-003.01A(3) for every enrolled child (per Nebraska Department of Health and Human Services (DHHS), Division of Public Health, Licensure Unit - Children's Services Licensing (Child Care Centers)).

Nebraska childcare centers are required to collect and maintain a completed Documentation of Criminal History Record Check (Nebraska State Patrol / local law enforcement; applicant, staff/volunteers age 19+, household members age 19+) - 391 NAC 3-003.01A(4), 3-006.03A for every enrolled child (per Nebraska Department of Health and Human Services (DHHS), Division of Public Health, Licensure Unit - Children's Services Licensing (Child Care Centers)).

Nebraska childcare centers are required to collect and maintain a completed Report of Law Enforcement Contact (applicant/director, staff/volunteers/household members age 19+; updated annually) - 391 NAC 3-003.01A(5), 3-006.03C for every enrolled child (per Nebraska Department of Health and Human Services (DHHS), Division of Public Health, Licensure Unit - Children's Services Licensing (Child Care Centers)).

Nebraska childcare centers are required to collect and maintain a completed Health Information Report for the director (form provided by the Department) - 391 NAC 3-003.01A(6), 3-006.03F for every enrolled child (per Nebraska Department of Health and Human Services (DHHS), Division of Public Health, Licensure Unit - Children's Services Licensing (Child Care Centers)).

Nebraska childcare centers are required to collect and maintain a completed Documentation of director qualifications - 391 NAC 3-003.01A(7), 3-006.04 for every enrolled child (per Nebraska Department of Health and Human Services (DHHS), Division of Public Health, Licensure Unit - Children's Services Licensing (Child Care Centers)).

Nebraska childcare centers are required to collect and maintain a completed Sketch/diagram/blueprint of facility (dimensions, room arrangement, outdoor play area) - 391 NAC 3-003.01A(8) for every enrolled child (per Nebraska Department of Health and Human Services (DHHS), Division of Public Health, Licensure Unit - Children's Services Licensing (Child Care Centers)).

Nebraska childcare centers are required to collect and maintain a completed Copies of zoning approval from the relevant jurisdiction - 391 NAC 3-003.01A(9) for every enrolled child (per Nebraska Department of Health and Human Services (DHHS), Division of Public Health, Licensure Unit - Children's Services Licensing (Child Care Centers)).

Nebraska childcare centers are required to collect and maintain a completed Fire Inspection Approval (fire marshal's office) - 391 NAC 3-003.01A(10) for every enrolled child (per Nebraska Department of Health and Human Services (DHHS), Division of Public Health, Licensure Unit - Children's Services Licensing (Child Care Centers)).

Nebraska childcare centers are required to collect and maintain a completed Sanitation Inspection Approval (Department or delegated authority) - 391 NAC 3-003.01A(11) for every enrolled child (per Nebraska Department of Health and Human Services (DHHS), Division of Public Health, Licensure Unit - Children's Services Licensing (Child Care Centers)).

Nebraska childcare centers are required to collect and maintain a completed Written Description of Services - 391 NAC 3-003.01A(12), 3-006.14A for every enrolled child (per Nebraska Department of Health and Human Services (DHHS), Division of Public Health, Licensure Unit - Children's Services Licensing (Child Care Centers)).

Nebraska childcare centers are required to collect and maintain a completed Sample daily schedule for each age group - 391 NAC 3-003.01A(13) for every enrolled child (per Nebraska Department of Health and Human Services (DHHS), Division of Public Health, Licensure Unit - Children's Services Licensing (Child Care Centers)).

Nebraska childcare centers are required to collect and maintain a completed Sample weekly menu of snacks and/or meals - 391 NAC 3-003.01A(14) for every enrolled child (per Nebraska Department of Health and Human Services (DHHS), Division of Public Health, Licensure Unit - Children's Services Licensing (Child Care Centers)).

Nebraska childcare centers are required to collect and maintain a completed Required licensing fee (see 3-004.08) - 391 NAC 3-003.01A(16) for every enrolled child (per Nebraska Department of Health and Human Services (DHHS), Division of Public Health, Licensure Unit - Children's Services Licensing (Child Care Centers)).

Nebraska childcare centers are required to collect and maintain a completed Child immunization record obtained within 30 days of each child's enrollment (not part of the initial license application) - 391 NAC 3-006.18, 3-006.18A; annual immunization reporting per 173 NAC 4 for every enrolled child (per Nebraska Department of Health and Human Services (DHHS), Division of Public Health, Licensure Unit - Children's Services Licensing (Child Care Centers)).

What forms are required for childcare enrollment in Nebraska?

Nebraska requires the following forms for each enrolled child: Complete, accurate, written and signed application and disclosure of ownership on a form provided by the Department (DHHS Application for Child Care Center license) - 391 NAC 3-003.01A(1); U.S. citizen / qualified alien attestation (Neb. Rev. Stat. ss 4-108 to 4-114) - 391 NAC 3-003.01A(2); Consent for Central Registry Checks and Authorization for Release of Information (applicant, all staff/volunteers age 13+, household members age 13+ if home-based) - 391 NAC 3-003.01A(3); Documentation of Criminal History Record Check (Nebraska State Patrol / local law enforcement; applicant, staff/volunteers age 19+, household members age 19+) - 391 NAC 3-003.01A(4), 3-006.03A; Report of Law Enforcement Contact (applicant/director, staff/volunteers/household members age 19+; updated annually) - 391 NAC 3-003.01A(5), 3-006.03C; Health Information Report for the director (form provided by the Department) - 391 NAC 3-003.01A(6), 3-006.03F; Documentation of director qualifications - 391 NAC 3-003.01A(7), 3-006.04; Sketch/diagram/blueprint of facility (dimensions, room arrangement, outdoor play area) - 391 NAC 3-003.01A(8); Copies of zoning approval from the relevant jurisdiction - 391 NAC 3-003.01A(9); Fire Inspection Approval (fire marshal's office) - 391 NAC 3-003.01A(10); Sanitation Inspection Approval (Department or delegated authority) - 391 NAC 3-003.01A(11); Written Description of Services - 391 NAC 3-003.01A(12), 3-006.14A; Sample daily schedule for each age group - 391 NAC 3-003.01A(13); Sample weekly menu of snacks and/or meals - 391 NAC 3-003.01A(14); Required licensing fee (see 3-004.08) - 391 NAC 3-003.01A(16); Child immunization record obtained within 30 days of each child's enrollment (not part of the initial license application) - 391 NAC 3-006.18, 3-006.18A; annual immunization reporting per 173 NAC 4.

How long must Nebraska childcare centers keep enrollment forms on file?

Nebraska childcare licensing rules require that child records, including all required enrollment forms, be kept on file for the duration of enrollment and for a retention period after the child leaves. Contact the Nebraska Department of Health and Human Services (DHHS), Division of Public Health, Licensure Unit - Children's Services Licensing (Child Care Centers) to confirm the exact retention schedule.

What happens if a Nebraska center is missing required child forms during an inspection?

Missing or incomplete required forms are a citable deficiency in a Nebraska childcare licensing inspection. Under 391 NAC 3-008.02 (Types of Disciplinary Action), DHHS may impose any one or a combination of: (1) a probationary license; (2) suspension or revocation of a provisional, probationary, or operating license; (3) a civil penalty of up to $5 per child - based on the number of children the program is authorized to care for on the effective date of the finding of violation - for each day the program is in violation; (4) restrictions on new enrollment; (5) restrictions/limits on the number or age of children served; or (6) other restrictions on the type of service provided. Unpaid fines constitute a debt to the State of Nebraska, collectible by lien foreclosure or court action in district court, and are remitted to the State Treasurer for credit to the permanent school fund (391 NAC 3-008.03). DHHS holds emergency power to issue an order without prior notice or hearing - including an immediate prohibition on the care of children - when an emergency requires immediate action to protect a child's physical well-being and safety; an affected person is afforded a hearing within 10 days of application (391 NAC 3-008.04). Statutory basis: Child Care Licensing Act, Neb. Rev. Stat. ss 71-1908 to 71-1923. ALL VERIFIED VERBATIM against the official 391 NAC 3 PDF.

Does TotReady provide templates for Nebraska required forms?

TotReady's enrollment form tool and incident report tool generate Nebraska-ready documents pre-filled with the required fields. Visit /tools/enrollment-form and /tools/incident-report to get started.