1. (a) Program managers shall ensure that for each child there is a “Child Care Registration and Emergency Information” (August 2025) form, completed by the parent or guardian, or an equivalent form on file on the child’s first day in attendance, in accordance with (b) below.

2. (b) The equivalent form allowed pursuant to (a) above shall include:

   1. (1) Full legal name of the child;
   2. (2) Child’s date of birth;
   3. (3) Child’s physical address and mailing address;
   4. (4) Child’s home telephone number;
   5. (5) Date of enrollment in the program;
   6. (6) The name, physical address, and mailing address of the parent(s) or guardians responsible for the child, if different from the child’s address;
   7. (7) Telephone numbers for the child’s parents or guardians and instructions as to how the parents or guardians can be contacted during the hours that the child is at the program;
   8. (8) Email addresses for the parents or guardians, if available;
   9. (9) Name and telephone number of at least one person who will assume responsibility for the child if, for any reason, the parents or guardians cannot be reached immediately in an emergency;
   10. (10) Any chronic conditions, allergies, or medications in case of sudden illness or injury;
   11. (11) Written parental or guardian permission for first aid treatment;
   12. (12) Written parental or guardian permission for emergency medical transportation and treatment; and
   13. (13) Names and telephone numbers of any person(s) other than parents or guardians who are authorized to remove the child from the program.

3. (c) The program shall ensure each child’s registration and emergency information form or an equivalent form contains the following statements:

   1. (1) “The licensing authority for this program is the child care licensing unit (CCLU) within the bureau of licensing and certification in the department of health and human services. Child care programs are required to post a copy of the most recent statement of findings (SOF) and the corresponding corrective action plan (CAP) in a location which is accessible to parents, and programs must maintain copies of the most recent SOF with CAP and make them available for parents to review upon request. SOFs and CAPs are also available on-line at: https://new-hampshire.my.site.com/nhccis/NH_ChildCareSearch or by contacting the unit at cclunit@dhhs.nh.gov or 603-271-9025.

      1. a. I give permission for child care licensing staff to speak with my child while with their class or group;
      2. b. I give permission for child care licensing staff to interview my child at the child care program separate from their class or group;
      3. c. I wish to be notified prior to child care licensing staff speaking with my child at the child care program separate from their class or group; and
      4. d. I do not give my permission for child care licensing staff to speak with my child while with their class or group.”; and

      WHAT WE DO: The CCLU regulates and oversees child day care programs for compliance with licensing rules. A licensing coordinator conducts a yearly, unannounced monitoring visit at every program, as well as an unannounced visit prior to the expiration of a license every three years. CCLU also investigates allegations of non-compliance with licensing rules. Information about CCLU can be found on our website: https://www.dhhs.nh.gov/programs-services/childcare-parenting-childbirth/child-care-licensing.

      CONVERSATIONS WITH CHILDREN – MONITORING VISITS: During routine monitoring visits, the Licensing Coordinator (LC) informally speaks with children to ask general questions about their day-to-day experiences in the child care program, using developmentally appropriate speech and language. The conversations and interactions take place while children are engaged in their daily routine with their class or group. At no time will a child be forced to speak with a LC.

      CONVERSATIONS WITH CHILDREN – COMPLAINT INVESTIGATIONS: During visits to investigate a complaint, if the LC believes your child may have relevant information, and that it would be best to interview your child separately, away from their class or group, the LC will ask the classroom staff which children they may interview, based upon your choice below. If you wish to be notified prior to an LC speaking with your child, the LC will contact you for permission to speak with your child either at the program but away from the group, or arrange a date, time, and location with you to speak with the child. If you approve the on-site conversation with your child, the LC will ask staff to recommend a place in the program. The LC will introduce themselves, ask your child their name, and explain that their job is to make sure child care programs are safe. The LC will ask your child if they want to talk to the LC about their child care. The LC will ask open-ended, non-leading questions, and at no time will your child be forced to speak with the LC.

      The LC will ask children questions such as: routines for snacks/lunch, handwashing, outdoor play, the rules, what happens when a child breaks a rule, rest/nap, fire drills, and what they like/dislike about child care.

      Based upon the information above, please indicate your preference:

   2. (2) “I hereby give permission for the staff of _______________________ to provide simple first aid treatment to my child, _________________________ when necessary. In the event of a more serious illness or injury, I give permission for my child to be transported to a hospital or other emergency medical facility to receive emergency medical treatment. I also authorize ambulance/rescue squad attendants to administer such treatment as is medically necessary, and I authorize licensed health care practitioners working in the hospital or emergency medical facility to examine and provide emergency medical treatment to my child if warranted. I understand that I will be contacted by child care program personnel as soon as possible regarding any emergency involving my child.”
4. (d) The program shall request and maintain on file for each child documentation of immunizations in accordance with RSA 141-C:20-a, RSA 141-C:20-b, and He-P 301.14.
5. (e) The documentation described in (d) above shall be on file on the first day the child is in attendance at the program or, pursuant to 45 CFR § 98, 41(a)(1)(i)(C), for children experiencing homelessness or for children in foster care within 60 days of the first date of attendance, to allow families or persons responsible for their care to obtain and provide documentation of immunizations.
6. (f) Exemptions from the immunizations required under (d) above shall be in accordance with RSA 141-C:20-c.

7. (g) The program shall obtain and maintain on file a child health screening form “New Hampshire Early Childhood Health Assessment Record” (August 2025), the first part completed and signed by the child’s parent or guardian, and the second part completed and signed by the child’s licensed practitioner,, or an equivalent record of physical examination, providing the following permission to exchange information:

   “I_______________________, authorize and request my child’s primary car provider to exchange information about my child’s health and development as pertains to this form with the program/school listed below. The information may be provided by phone, fax, mail, or in person. I understand that the disclosed information will be considered confidential and will be used only for the health and educational benefit of my child and family. Except as needed to comply with federal and state regulations, it will not be re-disclosed to any other person, school, or agency without my consent. I understand that this form will expire in one year unless I choose to cancel my permission in writing before that time.”

8. (h) The child health screening form shall be available for review by the department for each child no more than 60 calendar days after the date of admission.
9. (i) Programs shall not be required to obtain physical examination records for children whose parents or guardians object in writing, on the grounds that such physical examination is contrary to their religious beliefs.

Source. #2664, eff 3-30-84, EXPIRED 3-30-90 New. #4871, eff 7-24-90; ss by #5203, eff 8-16-91; ss by #6558, INTERIM, eff 8-16-97, EXPIRED: 12-14-97 New. #6719, eff 3-25-98; ss by #7294, eff 5-26-00; ss by #9160, INTERIM, eff 5-26-08; ss by #9310, eff 11-23-08 (from He-C 4002.11); ss by #12046, INTERIM, eff 11-19-16; ss by #12174, EMERGENCY RULE, eff 5-17-17; ss by #12415, eff 11-6-17; ss by #13373, eff 4-22-22; ss by #14356, eff 9-22-25, EXPIRES: 9-22-35