Data Reporting for Indian Tribes: ACF-700 Form
Index: CCDF-ACF-PI-2007-06| ACF-700 Form | Supplemental Narrative | Tribal Annual Report: Guide for CCDF Tribal Lead Agencies
Related Items: Child Care Bureau Regional Program Managers | ACF-700 Help
ACF-700 Form (also available in Excel)
CHILD CARE AND DEVELOPMENT FUND ANNUAL REPORT ON SERVICES PROVIDED FROM OCTOBER 1, 2006 THROUGH SEPTEMBER 30, 2007 |
OMB Control Number: 0980-0241 Expires:12/31/07 |
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COMPLETE NAME OF TRIBAL LEAD AGENCY ADDRESS CONTACT PERSON/PHONE/E-MAIL |
(A) TOTAL |
CATEGORY/TYPE OF CHILD CARE | ||||||||||
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. 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. |
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 child per month | ||||||||||||
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. at or below the poverty threshold for families of the same size b. above the poverty threshold but at or below 150 percent of the poverty threshold for families of the same size c. above 150 percent of the poverty threshold but at or below 200 percent of the poverty threshold for families of the same size d. above 200 percent of the poverty threshold for families of the same size |
a. b. c. d. |
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Comments: Public reporting burden for this collection of information is estimated to average 35 hours per response, including the time for reviewing instructions, gathering and maintaining the data needed, and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. |
Index: CCDF-ACF-PI-2007-06| ACF-700 Form | Supplemental Narrative | Tribal Annual Report: Guide for CCDF Tribal Lead Agencies |
Related Items: Child Care Bureau Regional Program Managers | ACF-700 Help |