Page 131

Official source

Child Care Subsidy Policy October 1, 2024 124 F. ECE-CC-1B Employment Verification Form G. ECE-CC-1C Self-Employment Ledger Form H. ECE-CC-0612B Change of Information Notification I. DAY-0613 Provider Notification Letter – Parent Eligibility J. Other correspondence with client 14.1.1.3. Policy Exception and Special Needs Documentation Block A. Documentation for Policy Exception Requests. B. Court Documents for court-ordered care. C. Documentation of Special Needs for children. 14.1.1.4. Legal Block A. DAY-0162 Child Care Services Parent Services Agreement B. DAY-0176 Child Care Certificate C. ECE-CC-19 Child Care Repayment Agreement D. IG-BR-29 Hearing/Grievance Request Form 14.1.2. Child Care Provider Files Maintained by the CCR&R Agency 14.1.2.1. Narrative Block A. ECE-CC-4 Child Care Provider File Cover Sheet B. ECE-CC-7 Information on Child Care Provider (copy)

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Page 131

Official source

Child Care Subsidy Policy October 1, 2024 124 F. ECE-CC-1B Employment Verification Form G. ECE-CC-1C Self-Employment Ledger Form H. ECE-CC-0612B Change of Information Notification I. DAY-0613 Provider Notification Letter – Parent Eligibility J. Other correspondence with client 14.1.1.3. Policy Exception and Special Needs Documentation Block A. Documentation for Policy Exception Requests. B. Court Documents for court-ordered care. C. Documentation of Special Needs for children. 14.1.1.4. Legal Block A. DAY-0162 Child Care Services Parent Services Agreement B. DAY-0176 Child Care Certificate C. ECE-CC-19 Child Care Repayment Agreement D. IG-BR-29 Hearing/Grievance Request Form 14.1.2. Child Care Provider Files Maintained by the CCR&R Agency 14.1.2.1. Narrative Block A. ECE-CC-4 Child Care Provider File Cover Sheet B. ECE-CC-7 Information on Child Care Provider (copy)