Dss form 2964-2025

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The document is a checklist for current child care facility staff and caregivers, required by the South Carolina Department of Social Services for licensing and regulatory purposes. It includes sections for verifying educational levels, training records, background checks, and health tests, as well as details about employment history and responsibilities within the facility.

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Click ‘Get Form’ to open the dss form 2964 in the editor.
Begin by entering the License/Registration/Approval Number at the top of the form. This is essential for identification purposes.
In SECTION 3, provide details about your current child care facility staff. Start with the County and Total Staff fields, ensuring accurate counts.
For each staff member, verify their educational level by listing their diploma or degree in the designated area. This information is crucial for compliance.
Complete the Training Record section by checking off required trainings such as BBP Training, CPR Infant/Child, and others as applicable.
Fill in personal details for each staff member including Date of Birth, Social Security Number, Employment Start and End Dates, and Position.
Ensure all necessary documents like DSS Forms 2926, 2925, and TB Test results are collected and verified by your Licensing Specialist.

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2010	4 Satisfied (41 Votes)

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