Note: This Program Instruction and its attachments apply to the FY 1999 ACF-700 data collection. For instructions on the FY 2000 data collection, see the new Program Instruction (ACYF-PI-CC-00-06). |
CCDF Reporting Instructions and Requirements for Indian Tribes (ACF-700) |
Index: ACYF-PI-CC-99-09 | Internet Registration Form | ACF-700 Form (page 1) | ACF-700 Form (page 2) | Instructions | ACF RAs | (Collection available in Word and PDF) |
Related Items: FY 2000 Program Instruction |
ACF-700 Reporting Form Page 1 (To print use Excel version) |
CHILD CARE AND DEVELOPMENT FUND ANNUAL REPORT |
OMB Approval Number: 0980-0241
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ON SERVICES PROVIDED FROM OCTOBER 1, 1998 THROUGH SEPTEMBER 30, 1999 |
Expires: 11/30/01
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COMPLETE NAME OF TRIBAL LEAD AGENCY: | CATEGORY/TYPE OF CHILD CARE | ||||||||||||||||||||||||
CARE PROVIDED BY A CCDF PROVIDER -- NO LICENSE CATEGORY AVAILABLE IN A |
CARE PROVIDED BY CCDF PROVIDER --
LICENSED OR REGULATED IN A |
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Address: | |||||||||||||||||||||||||
CHILD'S HOME BY A | FAMILY HOME BY A | GROUP HOME BY A |
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Contact Person/Phone/E-mail: | (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) |
(L)
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TOTAL | Relative | Non-Relative | Relative | Non-Relative | Relative | Non-Relative | Center | Child's Home | Family Home | Group Home |
Center
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1. Number of families receiving child care services | |||||||||||||||||||||||||
2 a. Average number of children served per month | |||||||||||||||||||||||||
2 b. Total number of children receiving child care services | |||||||||||||||||||||||||
3. Age breakdown of children receiving child care services: | |||||||||||||||||||||||||
a. 0 up to 1 year | a. | a. | a. | a. | a. | a. | a. | a. | a. | a. | a. | a. | |||||||||||||
b. 1 year up to 2 years | b. | b. | b. | b. | b. | b. | b. | b. | b. | b. | b. | b. | |||||||||||||
c. 2 years up to 3 years | c. | c. | c. | c. | c. | c. | c. | c. | c. | c. | c. | c. | |||||||||||||
d. 3 years up to 4 years | d. | d. | d. | d. | d. | d. | d, | d. | d. | d. | d. | d. | |||||||||||||
e. 4 years up to 5 years | e. | e. | e. | e. | e. | e. | e. | e. | e. | e. | e. | e. | |||||||||||||
f. 5 years up to 6 years | f. | f. | f. | f. | f. | f. | f. | f. | f. | f. | f. | f. | |||||||||||||
g. 6 years up to 13 years | g. | g. | g. | g. | g. | g. | g. | g. | g. | g. | g. | g. | |||||||||||||
h. 0 up to 13 years(sum of rows 3a thru 3g) | h. | h. | h. | h. | h. | h. | h. | h. | h. | h. | h. | h. | |||||||||||||
i. 13 - and older | i. | i. | i. | i. | i. | i. | i. | i. | i. | i. | i. | i. | |||||||||||||
4. Number of children receiving child care services because: | |||||||||||||||||||||||||
a. Parent is (or parents are) working | a. | ||||||||||||||||||||||||
b. Parent is (or parents are) in training or education program | b. | ||||||||||||||||||||||||
c. Child is receiving or in need of protective services | c. | ||||||||||||||||||||||||
5. Average number of hours of child care service provided per child per month | |||||||||||||||||||||||||
6. Average monthly amount paid for child care service per child | |||||||||||||||||||||||||
a. Average monthly CCDF subsidy | a. | ||||||||||||||||||||||||
b. Average monthly parent copayment | b. | ||||||||||||||||||||||||
7. Number of children receiving child care services from families with income: | ] | ||||||||||||||||||||||||
a. at or below the poverty threhold for families of the same size | a. | ||||||||||||||||||||||||
b. above the poverty threshold but at or below 150 percent of the poverty threshold for families of the same size | b. | ||||||||||||||||||||||||
c. above 150 percent of the poverty threshold
but at or below 200 percent of the poverty threshold for families
of the same size
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c. | ||||||||||||||||||||||||
d. above 200 percent of the poverty threshold for families of the same size | d. | ||||||||||||||||||||||||
Comments:
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Index: ACYF-PI-CC-99-09 | Internet Registration Form | ACF-700 Form (page 1) | ACF-700 Form (page 2) | Instructions | ACF RAs | (Collection available in Word and PDF) |
Related Items: FY 2000 Program Instruction |