Index: Technical Bulletin #1r-2 | ACF-800 Context Sensitive Help | ACF-800 Form | (Technical Bulletin also available in Word and PDF)
Revised ACF-800 Form (To print use Word or PDF version) |
CHILD
CARE AND DEVELOPMENT FUND ANNUAL AGGREGATE REPORT FOR SERVICES PROVIDED FROM _______________ THROUGH __________________ |
OMB
Approval Number: 0970-0150 Expires: 11/30/2009 |
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Complete Name of Grantee:
Contact Person, phone, email: |
( A ) TOTAL |
CATEGORY/TYPE OF CHILD CARE
|
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CARE PROVIDED BY A LICENSED OR REGULATED PROVIDER IN A | CARE PROVIDED BY A LEGALLY OPERATING PROVIDER (LICENSE CATEGORY UNAVAILABLE IN A STATE OR LOCALITY) IN A | |||||||||||
CHILD'S HOME BY A | FAMILY HOME BY A | GROUP HOME BY A | (L ) Center |
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( B ) Child's Home |
( C ) Family Home |
( D ) Group Home |
( E ) Center |
( F ) Relative |
(G ) Non-Relative |
( H ) Relative |
(I ) Non-Relative |
(J ) Relative |
(K ) Non-Relative |
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1. Number of families receiving child care services | ||||||||||||
2. Number of children receiving child care services | ||||||||||||
Payment Methods: |
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4. Number of children receiving child care services through certificates and/or cash |
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5. Of children served through certificates, number of children served through cash payments |
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6a. Number of child care providers receiving CCDF funding by type of care |
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6b. Total licensed capacity in centers and homes (No longer collected as of FFY 2003) |
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7. Estimated number of families receiving consumer education |
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How is the estimated number of families receiving consumer education determined? |
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Below, Indicate Methods Used on a Regular Basis: |
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8. Information to subsidized families concerning the choice of a certificate or grant/contract |
Y [
] N [ ] NA [ ] |
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9. Resource and referral counseling |
Y [
] N [ ] |
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10. List of legally operating child care providers |
Y [
] N [ ] |
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11. Brochure, booklet or written material about types of care and quality of care |
Y [
] N [ ] |
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12. Checklist of health and safety concerns |
Y [
] N [ ] |
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13. Copies of child care regulatory information |
Y [
] N [ ] |
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14. Familiarization with child care provider complaint policies (any method) |
Y [
] N [ ] |
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15. Mass media such as: television, radio, internet sites, billboards, etc. |
Y [
] N [ ] |
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16. Other (Please explain in next field) |
Y [
] N [ ] |
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If other indicated please explain. |
17. Is this report based on pooled CCDF and non-CCDF funds? | Y
[ ] N [ ] |
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18. If this report is based on pooled CCDF and non-CCDF funds, what is the percent of funds which are CCDF? | _________% |
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19. If this report is based on pooled CCDF and non-CCDF funds, please indicate which funds are included in the pool. |
CCDF Funds: Do you include Pre-K funds as part of Match or MOE: Y [ ] State funds used to match
Federal funds |
Non-CCDF Funds: Y [ ] N [ ] Title XX Y [ ] N [ ] State-only child care funds Y [ ] N [ ] Welfare to Work Y [ ] N [ ] Title IV-B or Title IV-E Y [ ] N [ ] Private/donated funds Y [ ] N [ ] Food Stamp child care funds Y [ ] N [ ] Non-compulsory school funds Y [ ] N [ ] TANF funds not transferred into Discretionary Fund Y [ ] N [ ] HUD child care funds Y [ ] N [
] Other: ____________________________________ |
20. State or Territory conducts routine unannounced inspections of regulated child care providers. As of FFY 2003, this information is no longer collected. | ||
21. Please enter explanatory comments regarding any of the data elements as appropriate. | (Optional) | |
22. Please attach any reports, materials, information developed as a result of the use of CCDF quality funds. | (Optional) |
Index: Technical Bulletin #1r-2 | ACF-800 Context Sensitive Help | ACF-800 Form | (Technical Bulletin also available in Word and PDF)