Index:
ACYF-PI-CC-05-06 | Instructions
| ACF-900 Form |
ACF-900 Child Care Report for High Performance Bonus (Form available in Excel.) |
OMB # 0970-0255
Expires 07/31/2008 |
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State: FFY: |
Age of Child | ||||||||||||||
Less than or equal to 12 Months |
Greater than
12-months & less than or equal to 24-months |
Greater than 24-months & less than or equal to 36-months |
Greater than 36-months & less than or equal to 48-months |
Greater than 48-months & less than or equal to 60-months |
Greater than 60-months & less than or equal to 72-months |
Greater than
72-months & less than or equal to 156 months |
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County
or Admin Region |
FIPS Code (include county FIPS Code or more than one county FIPS Code corresponding to an Admin Region.) | Centers | FCC- Homes |
Centers | FCC- Homes |
Centers | FCC- Homes |
Centers | FCC- Homes |
Centers | FCC- Homes |
Centers | FCC- Homes |
Centers | FCC- Homes |
County or Admin Region 1 |
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County or Admin Region 2 |
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County or Admin Region 3 |
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County or Admin Region 4 |
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County or Admin Region 5 |
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County or Admin Region 6 |
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County or Admin Region 7 |
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County or Admin Region 8 |
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County or Admin Region 9 |
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County or Admin Region 10 |
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County or Admin Region 11 |
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County or Admin Region N** |
*Please ensure that the FIPS codes entered above are equivalent to those given on the following web page. http://www.acf.hhs.gov/programs/ccb/report/formhelp/acf801/helpdocs/context.htm To top of Page
**This chart should be extended to include as many rows as necessary to reflect the number of counties or rate areas the State uses in determining its reimbursement rates to providers.
FCC-Home refers to Family Child Care Home
Index: Index: ACYF-PI-CC-05-06 | Instructions | ACF-900 Form Related Items: ACF Regional Administrators |