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Serving the community since 1968.

LCDJFS - Provider Documents

 

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Absent policy

Adjustment document 2012

Adjustment instructions

Caretaker information

Caretaker Provider Agreement

Categories for child care age groups

CC Link-up form

Child Care Termination Request

Child Information form

Client file checklist 2011

Communicable Disease Chart

Delinquent Co-pay Form

Fire Drill Report 2012

Infants and Toddlers in Home Child Care

JFS 01242 Medical Dental Emergency Plan

JFS 01280 Provider Medical Form

JFS 01297 Child Health and Enrollment form

JFS 01302 Request for Child Abuse and Neglect Form            

JFS 01305 Child Medical Statement

JFS 01329 Non-Conviction Statement 


JFS 01643 Type B Application

JFS 01644 Permission to Administer Medication

JFS 01923 Emergency Caregiver Statement

JFS 01926 Inspection Report

JFS 01933 Insurance Waiver

Manual Claim Form

Manual submission instructions

Pay Rate code for Type B Providers

Preschool and School Age in Home Child Care

Professional Pay Rate

Sample of Weekly Daily Activity Plan – Preschool

Sample of Weekly Daily Activity Plan – School Age

Sample of Weekly Daily Activity Plan - Toddlers

Sample of Weekly Daily Activity Plan – Mobile Infants

Sample of Weekly Daily Activity Plan – Young Infants

Swimming Permission

Weekly Program of Daily Activities – Preschool

Weekly Program of Daily Activities – School Age

Weekly Program of Daily Activities – Toddler

Weekly Program of Daily Activities - Infant

 

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