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CCA-1200A FORFF (4-16) ARIZONA DEPARTMENT OF ECONOMIC SECURITY Child Care Administration BEST OF CARE FORM This confidential form is to help your child care provider support the growth and development of your child while creating a safe, stable and healthy environment for all children. By providing complete information about your child, you will be assisting us in creating a positive experience for your child while in child care. Instructions: This form is to be completed by a parent/guardian and must be on file at the child care facility on or before a child’s first day of attendance. If additional space is needed, attach a separate sheet of paper. C h i l d

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Ca r e See reverse for EOE/ADA/LEP/GINA disclosures CCA-1200A (4-16) – Page 45 Arizona Department of Economic Security