Lactation Friendly Child Care Application
Thank you applying for the Lactation Friendly Child Care Recognition. Please make sure all required questions are completed and proper documents are uploaded. If you need assistance with this process please email info@healthychildcareco.org.
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Program Name
*
Program Email
*
example@example.com
Director/Provider Name
*
First Name
Last Name
Program Mailing Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
What is your license capacity?
*
Does your program accept CCCAP?
*
Yes
No
If your program accepts CCCAP, how many CCCAP students are enrolled?
*
How many children communicate with a primary language other than English?
*
How many children with special health needs are enrolled?
*
How many non-white students are enrolled?
*
How many infants are enrolled in your program?
*
How many toddlers are enrolled in your program?
*
How many preschool/pre-kindergarten children are enrolled in your program?
*
How many children are consuming breastmilk?
*
How many children are consuming formula?
*
Did your program receive recognition from the county or local health agency?
*
Yes
No
If "yes", please upload your certificate here
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BFCC Advisor Name
*
Copies of Staff Training Certificates on Breastfeeding
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Photographs of Breastfeeding Space
*
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Photograph's of Breastmilk Storage Space
*
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Photo or Copy of Breastfeeding Resources
*
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Copy of Breastfeeding Policy(ies) for family and staff
*
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Copy of Program Infant Feeding Plan
*
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Photo of Toys and Children's Books Supporting Breastfeeding
*
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Photo of Posters and/or Photos of Breastfeeding Parents and Animals
*
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