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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
ON SERVICES PROVIDED FROM OCTOBER 1, 1998 THROUGH SEPTEMBER 30, 1999
Expires: 11/30/01
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
Address:
CHILD'S HOME BY A FAMILY HOME BY A GROUP HOME BY A  
    
Contact Person/Phone/E-mail: (A) (B) (C) (D) (E) (F) (G) (H) (I) (J) (K)
(L)
TOTAL Relative Non-Relative Relative Non-Relative Relative Non-Relative Center Child's Home Family Home Group Home
Center
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
 c.  
d. above 200 percent of the poverty threshold for families of the same size d.  

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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