OMB control number

Defense Logistics Agency Child and Youth Program

OMB 0704-0582 · DOD/DODDEP.

OMB 0704-0582

The Department of Defense (DoD) requires the information in the proposed collection in support of Defense Logistics Agency (DLA) Child and Youth Programs (CYPs). This collection includes fourteen (14) DLA forms, some of which are used by all of the collection respondents and some of which are used under specific circumstances. The information collected is used for program planning, management, and health and safety purposes. More specifically, the information in the proposed collection allows CYP staff to provide safe, developmentally appropriate day care services and to ensure proper, effective response in the event of an emergency. Respondents include patrons enrolling their children in a CYP; these patrons may include active duty military, DoD civilian employees, or DoD contractors.

The latest form for Defense Logistics Agency Child and Youth Program expires 2022-02-28 and is listed under ICR 201811-0704-003.

View the official OMB control history on Reginfo.gov.

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
Document	Type
Form DLA Form 1855-1F DLA Child and Youth Program Consent to Perform Caregiving Health Practices and Authorization for Disclosure of Health Information	Form
Form DLA Form 1855-1F DLA Form 1855-1F	Form
Form DLA Form 1855-1E DLA Child and Youth Program Allergy Medical Action Plan	Form
Form DLA Form 1855-1E DLA Form 1855-1E	Form
Form DLA Form 1855-1D P DLA CYP Diabetes Emergency Medical Action Plan	Form
Form DLA Form 1855-1D P DLA CYP Diabetes Daily Medical Action Plan	Form
Form DLA Form 1855-1D P DLA Form 1855-1D	Form
Form DLA Form 1855-1C DLA Child and Youth Program Epilepsy/Seizure Medical Action Plan	Form
Form DLA Form 1855-1C DLA Form 1855-1C	Form
Form DLA 1855-1B DLA Child and Youth Program Special Diet Statement	Form
Form DLA 1855-1B DLA Form 1855-1B	Form
Form DLA Form 1855-1A DLA Child and Youth Program Respiratory Medical Action Plan	Form
Form DLA Form 1855-1A DLA Form 1855-1A	Form
Form DLA Form 1855-1 DLA Child and Youth Program (CYP) Health Assessment for Enrollment and Renewal	Form
Form DLA Form 1855 DLA Child and Youth Program (CYP) Health/Developmental Screening	Form
Form DLA Form 1855 DLA CYP Health Screening/Assessment (DLA Forms 1855/1855-1)	Form
Form DLA Form 1849-4 DLA CYP Child Illness/Injury Readmission Record	Form
Form DLA Form 1849-4 DLA Form 1849-4	Form
Form DLA Form 1849-3 DLA CYP Basic Care Item Consent to Apply	Form
Form DLA Form 1849-3 DLA Form 1849-3	Form
Form DLA Form 1849-2 DLA CYP Insect Repellent Use Consent	Form
Form DLA Form 1849-2 DLA Form 1849-2	Form
Form DLA Form 1849-1 DLA Child and Youth Program (CYP) Parental Consent for Field Trip	Form
Form DLA Form 1849-1 DLA Form 1849-1	Form
Form DLA Form 1855-1F DLA Child and Youth Program Consent to Perform Caregiving Health Practices and Authorization for Disclosure of Health Information	Form
Form DLA Form 1855-1E DLA Child and Youth Program (CYP) Allergy Medical Action Plan	Form
Form DLA Form 1855-1D P DLA Child and Youth Program Blood Glucose and Ketone Monitoring Log	Form
Form DLA Form 1855-1D P DLA CYP Diabetes Weekly Food and Carbohydrate Log	Form
Form DLA Form 1855-1D P DLA CYP Diabetes Emergency Medical Action Plan	Form
Form DLA Form 1855-1D P DLA CYP Diabetes Daily Medical Action Plan	Form
Form DLA Form 1855-1C DLA Child and Youth Program Epilepsy/Seizure Medical Action Plan	Form
Form DLA Form 1855-1B DLA Child and Youth Program Special Diet Statement	Form
Form DLA Form 1855-1A DLA Child and Youth Program Respiratory Medical Action Plan	Form
Form DLA Form 1855-1 DLA Child and Youth Program Health Assessment for Enrollment and Renewal	Form
Form DLA Form 1855 DLA Child and Youth Program Health/Developmental Screening	Form
Form DLA Form 1849-4 DLA CYP Child Illness/Injury Readmission Record	Form
Form DLA Form 1849-3 DLA CYP Basic Care Item Consent to Apply	Form
Form DLA Form 1849-2 DLA CYP Insect Repellent Use Consent	Form
Form DLA Form 1849-1 DLA Child and Youth Program (CYP) Parental Consent for Field Trip	Form
Form DLA Form 1849 Child and Youth Program (CYP) Medication Consent and Administration Log	Form
Form DLA Form 1849 Child and Youth Program Forms	Form
0704-0582_SSA_2.25.2022.docx	Supporting Statement A
DLA Form 1855-1F	Form
DLA Form 1855-1F	Form
DLA Form 1855-1E	Form
DLA Form 1855-1E	Form
DLA Form 1855-1D	Form
DLA Form 1855-1D	Form
DLA Form 1855-1D	Form
DLA Form 1855-1C	Form
DLA Form 1855-1C	Form
DLA Form 1855-1B	Form
DLA Form 1855-1B	Form
DLA Form 1855-1A	Form
DLA Form 1855-1A	Form
DLA CYP Health Screening/Assessment (DLA Forms 1855/1855-1)	Form
DLA CYP Health Screening/Assessment (DLA Forms 1855/1855-1)	Form
DLA CYP Health Screening/Assessment (DLA Forms 1855/1855-1)	Form
DLA Form 1849-4	Form
DLA Form 1849-4	Form
DLA Form 1849-3	Form
DLA Form 1849-3	Form
DLA Form 1849-2	Form
DLA Form 1849-2	Form
DLA Form 1849-1	Form
DLA Form 1849-1	Form
Child and Youth Program Forms	Form
Child and Youth Program Forms	Form
Child and Youth Program Forms	Form
Child and Youth Program Forms	Form
Child and Youth Program Forms	Form
Child and Youth Program Forms	Form
Child and Youth Program Forms	Form
Child and Youth Program Forms	Form
Child and Youth Program Forms	Form
Child and Youth Program Forms	Form
Child and Youth Program Forms	Form
Child and Youth Program Forms	Form
Child and Youth Program Forms	Form
Child and Youth Program Forms	Form
Child and Youth Program Forms	Form
Child and Youth Program Forms	Form
Child and Youth Program Forms	Form

All Historical Document Collections

Historical document collections
Reference	Filing	Received	Concluded	Action
202202-0704-005	Revision of a currently approved collection	2022-02-25		Approved without change
201811-0704-003	Existing collection in use without an OMB Control Number	2018-12-11		Approved without change

OMB Details

DLA Form 1849

Federal Enterprise Architecture: Defense and National Security - Operational Defense

Information collection instruments
Form	Name	Electronic access	Type
Form DLA 1849	Child and Youth Program (CYP) Medication Consent and Administration Log	Fillable Fileable Signable	Form

Review document collections for all forms, instructions, and supporting documents - including paper/printable forms.