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An Approved Relative provider application packet includes the following forms and verification requirements that must be completed and submitted to the Designee:

1. Approved Relative Child Care Provider Application CC42;

2. State of Alaska Substitute Form W-9;

3. Child Care Provider Rates and Responsibilities CC12, including verification the applicant is the only individual providing child care services;

4. Approved Child Care Provider Disaster Preparedness and Emergency Evacuation Plan CC10; 5. Approved Relative Child Care Provider Health and Safety Requirements CC11;

6. A copy of the applicant’s government issued photoidentification;

7. Verifiable valid State of Alaska business license to operate as a child care using the primary line of business of 62- Health Care and Social Assistance, and the primary North America Industry Classification System (NAICS) code of 624410 Child Care Services;

8. Typical Daily Schedule of Activities CC87;

9. A copy of valid pediatric first aid and cardiopulmonary resuscitation (CPR) certifications;

10. Verification of completion of the Child Care Assistance Approved Relative Provider Orientation;

11. Verification of the qualifying relationship of each child in care to the applicant;

12. Permission to Operate a Child Care Business CC72, if applicable;

13. A copy of the provider’s high school diploma, General Educational Development (GED) diploma, or the equivalent;

14. Valid Background Check The provider must also apply to the Alaska Background Check Program (BCP) as a facility in the New Alaska Background Check System (NABCS); obtain background checks for themselves and all