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DIVISION OF WELFARE AND SUPPORTIVE SERVICES Child Care Policy Manual 1. The Delegate Agency must accept the participant’s completed and signed Delegate Agency Enrollment form (contractor form) or Application for Child Care Subsidy form (DWSS form). 2. Required verifications listed below must be requested within ten (10) days from the date the application is received by the Delegate Agency. The customer must be given at least ten (10) calendar days to provide the required verifications. Refer to MS 133 regarding requesting additional information. a. A copy of identification for all required adult household members must be obtained. Refer to MS 212 for additional information required. b. Obtain the participant’s written self-disclosure (under penalty of perjury) of all non-financial factors of eligibility for all household members which include: • Age Note: If services are requested for a child between the ages of 13 years up to 19 years, the child must meet all the requirements for a child with special needs as listed in MS 211 and 211.1. • Social Security Numbers (SSN); refer to MS 213 regarding SSN requirements • Citizenship • Child Immunizations • Relationship (of applicant to household members) • Custody • Residency • Household Composition • Purpose of Care Schedule c. Inform custodial parents of the assistance listed below that can be provided through the DWSS Child Support Enforcement Program and provide the Child Support Services form 4000-EC to custodial parents if requested: • Locating the absent parent(s); • Establishing paternity; • Establishing and enforcing financial and medical support obligations; and • Collecting and distributing child support payments. d. Obtain a copy of valid foster license for all foster households. e. Obtain a copy of the placement letter or referral from the court or social service agency which defines the child as “foster” or “CPS” and the effective date of the transfer of custody. This documentation is required at the initial application for a child. f. Obtain the verification of purpose of care (refer to MS 219) for all required adult members and minor parents of the household. If the participant(s) does not meet a CCDP purpose of care, the household is not eligible for a child care subsidy. Exception: The Job Search and NEON Categories are not allowed for anyone applying with a Delegate Agency. Applicants applying for these categories must be referred to their designated CCR&R agency to complete an Application for Child Care Subsidy. 800- Delegate Agencies [2] MTL 01/24 July 1,2024