Mississippi Childcare Required Forms & Documents (2026)

Mississippi childcare centers are required to collect and maintain a completed MSDH Form #121 — Certificate of Immunization Compliance (required for each enrolled child before enrollment, and for staff and volunteers; child/staff authority at Rule 1.6.3(10); volunteer Form 121 at Rule 1.5.2(6)) for every enrolled child (per Mississippi State Department of Health (MSDH), Child Care Facilities Licensure Branch (Bureau of Child Care Facilities)).

Mississippi childcare centers are required to collect and maintain a completed MSDH Form #122 — Certificate of Medical/Religious Exemption (immunization exemption for children; religious-exemption portion does not apply to staff; Rule 1.6.3(10)) for every enrolled child (per Mississippi State Department of Health (MSDH), Child Care Facilities Licensure Branch (Bureau of Child Care Facilities)).

Mississippi childcare centers are required to collect and maintain a completed MSDH Form #333 — Fire Department Certificate of Inspection (submitted with application and license fees; Rule 1.2.4 Certificate of Inspection by Fire Department) for every enrolled child (per Mississippi State Department of Health (MSDH), Child Care Facilities Licensure Branch (Bureau of Child Care Facilities)).

Mississippi childcare centers are required to collect and maintain a completed Online Application for License (filed via www.healthyms.com; Rule 1.2.3, with fees under Rule 1.2.4) for every enrolled child (per Mississippi State Department of Health (MSDH), Child Care Facilities Licensure Branch (Bureau of Child Care Facilities)).

Mississippi childcare centers are required to collect and maintain a completed Online License Renewal form (Rule 1.2.7) for every enrolled child (per Mississippi State Department of Health (MSDH), Child Care Facilities Licensure Branch (Bureau of Child Care Facilities)).

Mississippi childcare centers are required to collect and maintain a completed Letter of Suitability — issued by the MSDH Criminal Records Check Unit after a fingerprint-based comprehensive background check; required before any prospective staff member may begin work, and for volunteers serving 120+ hours/licensure year (Rule 1.5.2) for every enrolled child (per Mississippi State Department of Health (MSDH), Child Care Facilities Licensure Branch (Bureau of Child Care Facilities)).

What forms are required for childcare enrollment in Mississippi?

Mississippi requires the following forms for each enrolled child: MSDH Form #121 — Certificate of Immunization Compliance (required for each enrolled child before enrollment, and for staff and volunteers; child/staff authority at Rule 1.6.3(10); volunteer Form 121 at Rule 1.5.2(6)); MSDH Form #122 — Certificate of Medical/Religious Exemption (immunization exemption for children; religious-exemption portion does not apply to staff; Rule 1.6.3(10)); MSDH Form #333 — Fire Department Certificate of Inspection (submitted with application and license fees; Rule 1.2.4 Certificate of Inspection by Fire Department); Online Application for License (filed via www.healthyms.com; Rule 1.2.3, with fees under Rule 1.2.4); Online License Renewal form (Rule 1.2.7); Letter of Suitability — issued by the MSDH Criminal Records Check Unit after a fingerprint-based comprehensive background check; required before any prospective staff member may begin work, and for volunteers serving 120+ hours/licensure year (Rule 1.5.2).

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

Mississippi 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 Mississippi State Department of Health (MSDH), Child Care Facilities Licensure Branch (Bureau of Child Care Facilities) to confirm the exact retention schedule.

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

Missing or incomplete required forms are a citable deficiency in a Mississippi childcare licensing inspection. Monetary penalties under Rule 1.25.9 (authority Miss. Code Ann. §43-20-8). Class I violations (e.g., failure to prevent death/burns/dismemberment/permanent disability of a child; child left unattended) — $500 first occurrence, $1,000 each subsequent occurrence of the same violation; two Class I citations on separate occasions may cause suspension/revocation (Rule 1.25.9(2)–(3)). Class II violations (e.g., personnel requirements/records, emergency preparedness/evacuation planning, staff-to-child ratio/group size/supervision, discipline and guidance, exceeding capacity, releasing a child to an unauthorized individual, environmental health, failure to report a serious occurrence or communicable disease, transportation, immunization documentation in child/employee records, nutrition standards) — $50 first occurrence, $100 each subsequent occurrence within the same licensure term; four Class II citations on separate inspection dates may cause suspension/revocation (Rule 1.25.9(4)–(5)). Class III violations (any violation not listed as Class I or II) — $25 each occurrence (Rule 1.25.9(6)). Penalties payable within 30 business days; appeal of a monetary penalty must be filed within 10 business days (Rule 1.25.9(7)–(8)). No license is granted or renewed for an operator with outstanding monetary penalties (Rule 1.25.9(9)). License may also be denied, suspended (including emergency suspension), restricted, or revoked under Subchapter 25 (Rules 1.25.1–1.25.2), and MSDH may seek an injunction (Rule 1.25.7).

Does TotReady provide templates for Mississippi required forms?

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