Page 71

CAPS Policy – Provider Rights and Responsibilities No.: CAPS/00-12 Effective Date: 10/01/2016 Revised: 03/02/2026 Revision Effective: 03/02/2026

CAPS Policy Manual

Page 71 of 109 is to support provider compliance. Failure to provide records in a timely manner may result in a referral to DECAL’s Audits and Compliance Division. B. DECAL’s Audits and Compliance Division conducts risk-based compliance reviews and investigates referrals. (1) For compliance reviews, providers are typically required to submit arrival and departure records and transportation records for a specified three-month period within 15 calendar days from the date the notice was received. The review period may be widened at DECAL’s discretion. The purpose of compliance reviews is to identify and recoup improper payments; however, additional sanctions may also be imposed at the discretion of CAPS administration. (2) For investigations, DECAL may request records in person or in writing. The timeframe for which records are requested will vary based on dates specified in the referral. The review period may be widened at DECAL’s discretion. (3) If records are requested in writing by DECAL, failure of the provider to submit the required documents in 15 calendar days from the date the notice was received shall cause an overpayment to be established for any period where documentation is not provided, and result in sanctions imposed by DECAL, including a mandatory reclaim of reimbursement for the overpayment periods that lack the supporting documentation, and may include dismissal or disqualification from CAPS and may jeopardize the provider’s ability to participate in other DECAL programs. (4) If records are requested in person during an on-site review, the provider or any of their representatives must immediately make records available. If the provider’s designated program director cannot be present at the time of review, the director must select an alternate person to access the records in their absence. The absence of the director should not hinder or prevent a DECAL representative from conducting a review. (5) Failure to provide requested documentation immediately upon request shall result in sanctions imposed by DECAL, including a mandatory reclaim of reimbursement for the overpayment periods that lack the supporting documentation, and may include dismissal or disqualification from CAPS and may jeopardize the provider’s ability to participate in other DECAL programs. (6) Established overpayments will be sent to CAPS to begin the recoupment process, which will reduce future payments to the provider. All overpayments must be satisfied within 24 months of establishment. 12.4.7.4 Provider records should be securely maintained on site where care is provided or at a suitable off-site location previously approved by DECAL that allows for convenient access and retrieval if immediate review is requested. DECAL shall have the authority to enter the premises to retrieve requested documents. The following section of the Child Care Provider Agreement shall be completed by the person legally responsible for the operation and management of the program:

The documents for: _________________________________________________________

(provider name)

will be maintained at: _________________________________________________________

(address, city, zip code where records will be stored)

12.4.7.5 If at any time any records pertaining to the CAPS program are relocated from the previously approved location, a notification must be submitted to CAPS for approval within five business days. 12.4.7.6 In the event of natural or man-made disasters (e.g., flooding, fire, hurricane, tornado, theft, acts of vandalism, etc.), the provider is responsible for notifying CAPS within five business days. The provider is responsible for providing third-party verification to substantiate the disaster. Verification may include police reports, insurance company claims, photos, or other proof that supports the disaster and must also include details of the property impacted. Claims related to man-made disasters must be made and filed within 30 calendar days of the incident. Claims related to natural disasters must be filed as soon as possible in accordance with insurance company regulations. In the event of provider electronic attendance tracking system functionality failure, the provider must still maintain records as prescribed in CAPS policy. The