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Child Care Services Forms


After School Program Enrollment Certification
CD-9608A (DOC; 26KB; 1p.)

Annual Summary of Eleven-and Twelve-Year-Old Children in Child Development Division Child Care Programs CD-9608Bx (XLS; 35KB; 2pp.) | DOC (DOC; 61KB; 2pp.)

Attendance and Fiscal Reporting forms are available through the Child Development Fiscal Services Web site.

Attestation of Qualifed Staff and Ratio Requirements
CD-3701A (DOC; 47KB; 2pp.)

Calendar Fiscal Year 2011-12
CD-9730 (DOC; 187KB; 2pp.)

Calendar Fiscal Year 2012-13
CD-9730 (XLS; 47KB; 1p.)

Child Care Data Collection Privacy Notice and Consent Form
CD-9600A (DOC; 28KB; 1p.)
Available Translations of the Child Care Data Collection Privacy Notice and Consent Form


Child Development Data Reporting
CDD-801A and CDD-801B

Child Ratio Schedule
CD-3705 (DOC; 42KB; 1p.)

Confidential Application for Child Development Services and Certification of Eligibility
CD-9600 (DOC; 134KB; 5pp.)
Available Translations of the Confidential Application for Child Development Services and Certification of Eligibility

Continued Funding FY 2012-13
FY 2012-13 Continued Funding Application Instructions
(PDF; 101KB; 9pp.)
FY 2012-13 Continued Funding Application
CD-3704 (PDF; 545KB; 7pp.)

Desired Results Materials and Forms

Emergency and Identification Information
CD-9607 (DOC; 30KB; 1p.)
Available Translations of the Emergency and Identification Information

Enrollment and Attendance Register  Requires 11 x 17 paper.
CD-9400 (DOC; 191KB; 1p.)

Equipment Inventory
CD-8604 (DOC; 40KB; 1p.)

Equipment Purchase Approval
CD-2703 (DOC; 46KB; 1p.)

Mandatory Annual Health and Safety Training Expenditure Report
CD-5004 (XLS; 30KB; 1p.)

Notice of Action
CD-7617 (DOC; 104KB; 2pp.)
Available Translations of the Notice of Action

Notification and Certification for 11 and 12-Year-Old Children
CD-9608 (DOC; 28KB; 1p.)
Available Translations of the Notification and Certification for 11 and 12-Year-Old Children

Out of State Travel
CD-2700 (DOC; 33KB; 1p.)

Payee Data
STD.204 (PDF; 1,105KB; 2pp.)

Personnel Roster for Program Self-Evaluation

CD-3701 (DOC; 71KB; 2pp.)

Personnel Roster to Maintain at Site
CD-3701B (DOC; 91KB; 3pp.)

Prekindergarten and Family Literacy Program (PKFLP) Site Change Request and Eligibility Form
CD-PKFLP (DOC; 49KB; 2pp.)

Program Narrative Change FY 2011-12
CD-3704A (DOC; 38KB; 1p.)

Program Narrative Change FY 2012-13
CD-3704A (PDF; 497KB; 1p.)

Program Self-Evaluation FY 2010-11 Attachment 1 Instructions

Program Self-Evaluation FY 2010-11 Attachment 2 Instructions and Forms
(DOC; 177KB; 14pp.)

Resource and Referral Program Service Data Report
The online data report (CD 2504E) completed by Resource and Referral contractors and instructions regarding obtaining an agency password and completing reports.

Site Supervisor or Program Director Staffing Qualifications Waiver Request
CD-7701A (PDF; 514KB; 4pp.)

Site Supervisor or Program Director Staffing Qualification Waiver Extension Request
CD-7701B (PDF; 502KB; 2pp.)

Statement of Incapacity
CD-9606 (DOC; 48KB; 1p.)
Available Translations of the Statement of Incapacity

 


 

Questions:   Child Development Division | 916-322-6233
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