/ Application for approval of premises
Children’sServicesAct1996,Children’sServicesRegulations2009

Aboutthisapplication

•Forachildren’sservicetooperate,thepremisesmustfirstbeapprovedassuitablebytheSecretaryorDelegateoftheDepartmentofEducationandTraining(theDepartment).Withoutpremisesapproval,achildren’sservicecannotbelicensed.

Typesofservices

Thisapplicationreferstodifferenttypesofservices.Thetypesofservicesanddescriptionsofeachareprovidedbelow.

  • Standard:Achildren’sservicethatisanearlychildhoodinterventionservice;oranoccasionalcareservice;oramobileservice;orabudgetbasedservice.

Limitedhours:

  • Type1.Achildren’sserviceestablishedtocarefororeducateeachchildfornotmorethan2hoursadayandnotmorethanatotalof6 hoursaweek.
  • Type2.Achildren’sserviceestablishedtocarefororeducateeachchildfornotmorethan5hoursadayandnotmorethanatotalof15 hoursaweek.

Shortterm:

  • Type 1. A children’s service established to care for or educate children for not more than 120 days in a 12 month period.
  • Type 2. A children’s service establishedto care for or educate children for not more than 72 hours in a 3 month period.

•Schoolholidayscare:Achildren’sservicethatisestablishedtocarefororeducateschoolchildrenfornomorethan4weekspercalendaryearduringschoolholidays.

•Integratedservice:Achildren’sservicethatconsistsof2ormoretypesofchildren’sservice(otherthanashorttermservice)providedatonepremisesbyonelicensee.

•Associatedchildren’sserviceisachildren’sservicethatisoperatedatthesameplaceasanapprovededucationandcareserviceundertheEducationandCareServicesNationalLawAct2010andEducationandCareServicesNationalRegulations2011.

Approvalofpremisesdoesnotapplytoassociatedchildren’sservicesorapprovedassociatedchildren’sservices.

Whatyouneedtodobeforelodgingthisapplication

•Youmustcollectandprovidearangeofdocumentsshowingthelayout,thespaceprovidedandsuitabilityofthepremises.

•Thedocumentsyouneedtoprovideaspartofthisapplicationdependonthetypeofservicetobeconductedatthepremises.

Forschoolholidaycareservicesitalsodependson whethertheserviceisoperatedataregisteredschooloratalocationthatisnota registeredschool.

•AfulllistofdocumentsisshownintheDocumentChecklistonpage2.Thechecklistdetailsthetypeofdocument,whocompletesitand whetheritneedstobeprovidedforthetypeofserviceproposedtooperate.

•Wherepossible,plansshouldbenogreaterthanA3insize.

Furtherinformation

•Furtherinformationaboutoperatingachildren’sserviceisavailableat

PrivacyTheSecretarytotheDepartmentofEducationandTrainingiscommittedtoresponsibleandfairhandlingofpersonalinformation,consistentwiththe InformationPrivacyAct2001 (Vic),the HealthRecordsAct2001 (Vic)and otherstatutoryobligationsincludingobligationsundertheChildren’sServicesAct1996(Vic).TheDepartmentofEducationandTrainingmayneedtodiscloseyourpersonalinformationtootherStateandCommonwealthagenciestocheckorconfirmtheinformationyouhaveprovided.Youcanrequestaccesstoorupdateyourpersonalinformationbycontactingus.Ourinformationprivacypolicyisavailableat

CS1

Version (01/11/11)

DocumentChecklist

Ifanintegratedserviceisproposedatthepremises,youonlyneedtoprovideonecopyofeachdocumentbutyoumustensureyouincludetherequiredinformationforeachtypeofservice.

Documentinformation / Isdocument/information
requiredforthistypeofservice? / A T T A C H E D
Name ofdocument / Informationthatmustbe
shownon documentfor children’sservice / Who needsto
complete / Standard / School
Holidays Care
(at registered
school) / School
Holidays Care
(notat
registered school) / Limited
Hours
(all) / Short
term
(all)
SitePlan(final) / Showing buildingsand surrounding areas. / Aregistered building practitioner for all exceptschool holidayscare or shorttermtype 2 service. / Yes / No / Yes / Yes / Yes
Elevationplans of the premises / Aregistered building practitioner for all exceptschool holidayscare service. / Yes / No / Yes / Yes / No
DiagramorFloor Planof children’s roomsand outdoorspace on premises
(ora combination of both) / Showing allindoor and outdoor space.For each room,provide a unique number (egroom1,room 2,room3etc) and a description (e.g.children’s room,children’s outdoor space,kitchen,toiletetc). / Aregistered building practitioner for allexceptschool holidayscare at registeredschools or shorttermtype 2 service. / Yes / Yes / Yes / Yes / Yes
Diagramor descriptionof outdoorspace not onpremises / For any outdoor space not included onthe premises ofthechildren'sservice,a briefdescription or diagramofwhere the outdoor space islocated. / Notrequired to be completed bya registered building practitioner. / No / Yes / Yes / No / No
Acompleted Children’sService Area Measurements form / Thatshowsthe measurementsforthe children’sroomsand outdoor space. / Aregistered building practitioner for all exceptschool holidayscare at registeredschools or shorttermtype 2 service. / Yes / Yes / Yes / Yes / Yes
Soilassessment ifnot previously supplied / The nature,extentand levelsofcontamination and ifanycontamination, the actualorpotential risk to human health resulting fromthatcontamination. / An environmental consultant, environmental consultingfirm,or environmental auditor. / Yes / No / Yes,if outdoor spaceat premises / Yes,if outdoor spaceat premises / No
Planningpermit ifthe buildingis being constructed or is otherwise required bythe Planning and EnvironmentAct 1987 / Detailing appropriate planning approvalfor the building or works. / RelevantCouncil or qualified practitioner. / Yes / No / Yes / Yes / Yes
Buildingpermit ifthe buildingis being constructed or is otherwise required bythe BuildingAct1993 / Detailing appropriate planning approvalfor the building or works. / RelevantCouncil or qualified practitioner. / Yes / No / Yes / Yes / Yes
Occupancypermit, certificate of final inspectionor buildingsurveyor’s statement / Ifyou havethisdocument now,attach withthe applicationor ifnotyet available can besubmitted ata later datebeforethe finalapprovalof premises. / RelevantCouncil or qualified practitioner. / Yes / No / Yes / Yes / Yes

Applicant’sdetails

1.Whattypeofapplicantareyou?

Individual

Title (Mr etc)Family NameGiven namesDateofBirth

ABN(if applicable)Daytime telephone number(AH)emergencycontactnumber

FaxnumberEmailaddress

BodyCorporate CompanyIncorporatedassociationCooperativePartnershipCorporation/GovernmentSchoolCouncil

Fullnameofcompany,incorporatedassociation,cooperative,partnershiporcorporation/GovernmentSchoolCouncil

ACN(if applicable)ABN(ifapplicable)

2.Postaladdress

Buildingname(ifapplicable)

Unit,floor,streetnumberandstreetnameorPOboxSuburb/TownStatePostcode

3.Providedetailsofthecontactpersonforanyenquiriesandcorrespondenceaboutthisapplication.

Yourself astheindividualapplicantORanalternativecontactpersonnominatedbelowORthenameofthecontactpersonforthebodycorporate

Title (Mr,Mrs,etc)Family NameGivennames

Daytime telephonenumber(AH)emergencycontactnumberFaxnumber

Emailaddress

PostaladdressSameaspostaladdressinquestion2ORDifferentpostaladdressspecifiedbelowBuildingname(ifapplicable)

Unit,floor,streetnumberandstreetnameorPOboxSuburb/TownStatePostcode

Children’sservicepremisesdetails

4.Nameofchildren’sservice(ifknown)

5.Addressofchildren’sservicepremises(P.O.boxescannotbeaccepted)

Unit,floor,streetnumberandstreetnameSuburb/TownStatePostcodeVIC

6.InwhichLocalGovernmentAreaistheservicelocated?(e.g.PortPhillip,SwanHill)

7.Isthislocationaregisteredschool?

No� Go to question8.

Yes� Nameof schoolSchoolregistrationnumber

8.AfterwhichdatewillthepremisesbereadyforinspectionbytheDepartmentofEducationandEarlyChildhoodDevelopment?

Typesofservices

9.Whattypesofservicesareintendedtooperateatthepremises?Refertothedescriptions onpage1andchooseallthatapply

Typeofservice / Tick/Checktheboxbelowifprovidingthistypeofservice / Agesofchildren
(range) / Proposedcapacityatpremises(maximum numberofchildren’splaces)
Standard
Schoolholidays
LimitedhoursType1
LimitedhoursType2
Integrated(2ormoreoftheserviceslisted above.Make sure you have tickedand provided detailsofrelevantservicesabove) / Integratedservicetotalnumber ofchildren’s places (add numbersateachservice andwrite here)
ShorttermType1
ShorttermType2

Declarationandsignature

10.Ideclare/certifythat:

•theinformationinthisapplicationandanyattachmentsaretrueandcorrect.

•ifabodycorporateapplicant,thisapplicationissignedinaccordancewiththerulesgoverningthebodycorporatelegalentity.

•ifintendingtooperateanschoolholidayscareservice,Ideclarethatalloutdoorspaces,oroutdoorspaceequivalentsprovideauseableareaofatleast7squaremetresperchildandcomplywithregulation98oftheChildren’sServicesRegulations2009.

Whomustsign:

Individuals:Theindividualapplicant.

Company:Twodirectorsofthecompany,oradirectorandcompanysecretary,orifsoleproprietorthesoledirector.Incorporatedassociation:ThePublicOfficerandoneothermemberofthemanagementcommittee.

Cooperative:Twodirectorsofthecooperative,oradirectorandoneotherofficerofthecooperative.

Partnership:Amanagingpartnerwhoisauthorisedtosignonbehalfofthepartnership.Thissignaturebindsallpartners.Corporation/GovernmentSchoolCouncil:Signedinaccordancewithrulesofthecorporation/council.

SignaturePrintednamePosition (if bodycorporate)Date

X

SignaturePrintednamePosition (if bodycorporate)Date

X

Whattodonext

Attachdocuments

•Makesureyouhaveattachedallrelevantdocumentsspecifiedinthedocumentchecklistonpage2oryourapplicationwillbedelayed.

Paytheapplicationfee

•Theapplicationfeemustbepaidatthetimeofapplication.Thereis noGSTpayableonanyfee.

•Thefeeamountdependsonthenumberofchildren’splacesyouareproposingtoprovide.Feeamountsarelistedinthefeessheetat

Howtopay

•Bychequemadepayableto‘DepartmentofEducationandTraining’.

Lodgeyourapplication

•Bypostingto:DepartmentofEducationandTraining

QualityAssessmentandRegulationDivision

Children’sServicesAdministrationandSupportUnitGPOBox4367MelbourneVictoria3001

Whathappensthen

•Youwillreceiveanacknowledgementthatyourapplicationhasbeenreceived.Youmayneedtoprovidefurtherinformation.

•Ifanychangeoccursintheinformationyouhaveprovidedinyourapplication,youmustnotifytheDepartmentofEducationandTrainingassoonaspossible.

•Whentheformiscompletedcorrectlyandallnecessarydocumentsareprovided,within30daysaChildren’sServicesAuthorisedOfficerwillcontactyoutoarrangeanonsiteinspectionofthepremises.

•Ifyourapplicationissuccessful,youwillreceiveaCertificateofApprovalofPremises.