Data Reporting for Indian Tribes; ACF-700 Form |
Index: ACYF-PI-CC-01-09 | ACF-700 Form | Tribal Annual Report: Guide for CCDF Tribal Lead Agencies (updated 11/2001) |
Related Items: ACF Regional Administrators | ACF-700 Help | CCDF Annual Report for Tribal Lead Agencies (11/2000) |
ACF-700 Form (also available in Excel) |
CHILD
CARE AND DEVELOPMENT FUND ANNUAL REPORT ON SERVICES PROVIDED FROM OCTOBER 1, 2000 THROUGH SEPTEMBER 30, 2001 |
OMB
Approval Number: 0980-0241
Expires:11/30/04 |
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COMPLETE NAME OF TRIBAL LEAD AGENCY: ADDRESS: CONTACT PERSON/PHONE/E-MAIL: |
(A) TOTAL |
CATEGORY/TYPE OF CHILD CARE | ||||||||||
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CARE PROVIDED BY A CCDF PROVIDER -- NO LICENSE CATEGORY AVAILABLE IN A | CARE PROVIDED BY A CCDF PROVIDER --LICENSED OR REGULATED IN A | |||||||||||
CHILD'S HOME BY A | FAMILY HOME BY A | GROUP HOME BY A | (H) Center |
(I) Child's Home |
(J) Family Home |
(K) Group Home |
(L) Center |
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(B) Relative |
(C) Non-Relative |
(D) Relative |
(E) Non-Relative |
(F) Relative |
(G) Non-Relative |
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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 b. 1 year up to 2 years c. 2 years up to 3 years d. 3 years up to 4 years e. 4 years up to 5 years f. 5 years up to 6 years g. 6 years up to 13 years h. 0 up to 13 years(sum of rows 3a thru 3g) i. 13 - and older |
a. |
a. b. c. d. e. f. g. h. i. |
a. b. c. d. e. f. g. h. i. |
a. b. c. d. e. f. g. h. i. |
a. b. c. d. e. f. g. h. i. |
a. b. c. d. e. f. g. h. i. |
a. b. c. d. e. f. g. h. i. |
a. b. c. d. e. f. g. h. i. |
a. b. c. d. e. f. g. h. i. |
a. b. c. d. e. f. g. h. i. |
a. b. c. d. e. f. g. h. i. |
a. b. c. d. e. f. g. h. i. |
4.
Number of children receiving child care services because: a. Parent is (or parents are) working b. Parent is (or parents are) in training or education program c. Child is receiving or in need of protective services |
a. b. c. |
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5.
Average number of hours of child care service provided per week per child per month |
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6.
Average monthly amount paid for child care service per child a. Average monthly CCDF subsidy b. Average monthly parent copayment |
a. b. |
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7.
Number of children receiving child care services from families
with income: |
a. |
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Comments: |
Index: ACYF-PI-CC-01-09 | ACF-700 Form | Tribal Annual Report: Guide for CCDF Tribal Lead Agencies (updated 11/2001) |
Related Items: ACF Regional Administrators | ACF-700 Help | CCDF Annual Report for Tribal Lead Agencies (11/2000) |