FREQUENCY OF PAY: Weekly Bi-Weekly (26 pays/year) Twice a Month (24 pays/year) Monthly THE EMPLOYEE: Receives pay stubs Does not receive pay stubs Receives pay in CASH Has access

EVF 2/2015

Employee’s Name: _______________________________________________________________ First Name Last Name

Place of Employment:

Address of Employment: Employer’s Telephone Number

(______)_______-__________

I authorize the release of this information and give permission to the Child Care Information Services (CCIS) agency to verify all information contained in this form.

X________________________________________________________________________________________ __________________________________________ Employee’s Signature Date

THIS SECTION MUST BE COMPLETED BY THE EMPLOYER Employer Identification Number (EIN): EMPLOYEE INFORMATION: Employee’s Job Title: Is the above-mentioned employee newly hired: Yes No Employment Start Date: ______/_______/______

EMPLOYMENT INCOME: HOURLY RATE: $

AVERAGE DAILY TIPS: $

GROSS PAY: $

NEXT PAY DATE:

____/_____/_____

FREQUENCY OF PAY: Weekly Bi-Weekly (26 pays/year) Twice a Month (24 pays/year) Monthly

THE EMPLOYEE: Receives pay stubs Does not receive pay stubs Receives pay in CASH Has access to pay information online via the following website: _________________

EMPLOYMENT SCHEDULE (Please indicate the days and hours the employee works and indicate whether the hours occur during A.M. or P.M) NOTE: If the schedule varies, please give a 4-week sample schedule. WEEK ONE Dates: from_______________ to_________________

Mon. from ______A.M/P.M to______ A.M/P.M Tues. from ______A.M/P.M to______ A.M/P.M Wed. from ______A.M/P.M to______ A.M/P.M Thur. from ______A.M/P.M to______ A.M/P.M Fri. from ______A.M/P.M to______ A.M/P.M Sat. from ______A.M/P.M to______ A.M/P.M Sun. from ______A.M/P.M to______ A.M/P.M

TOTAL # HOURS/WEEK:____________________

WEEK TWO Dates: from_______________ to_________________


TOTAL # HOURS/WEEK:____________________

WEEK THREE Dates: from____________ to_______________


TOTAL # HOURS/WEEK:____________________

WEEK FOUR Dates: from______________ to________________


TOTAL # HOURS/WEEK:____________________

Effective Begin Date of Schedule change: _____/_____/_______

EXTENDED LEAVE Is the employee on extended leave (maternity, disability, etc.)? Yes No Effective begin date of extended leave: _____/_____/_____ Date returned from extended leave:____/____/____ TEMPORARY/SEASONAL EMPLOYMENT Is the employee considered to be a temporary hire? Yes No If the employee is considered a temporary hire, what is the last date of guaranteed employment? ______/______/_______

If the employee is seasonal, please give: Last day of work before break:______/_______/_______ Expected date of return following break: _________/________/_________

I understand that the information I am providing will be used to determine the above-named employee’s eligibility for subsidized child care. X _____________________________________________________________________________________________________ ________________________________________ Employer’s Signature Date

Please Print your name:_______________________________________________________________________ Job Title:___________________________________________________________

Employment Verification Form for:

EVF 2/2015

Dear Employer: One of your employees has requested assistance paying his/her child care costs. We must verify his/her employment with you. This information will help us determine if this employee us eligible for the subsidized child care program. The form can be returned to the employee or mailed directly to the Child Care Information Services (CCIS) agency.

We must have an accurate record of your employee’s work schedule. Please complete the information on the back of this page. It is very important that the hours shown are specific and defined as either A.M. or P.M. (For example, 7:30 a.m. – 3:30 p.m.). If the employee’s schedule varies, please give a 4-week sample schedule. You do not need to give a 4-week sample schedule unless the employee’s schedule varies from week to week. Thank you for your time and assistance. If you have any questions about how to complete this form, please contact the CCIS listed below.

Employee Verification Form

An authorized COMPANY REPRESENTATIVE (not the employee) must complete this form.

marmoy

CCIS

EVF 2/2015

Employee’s Name: _______________________________________________________________ First Name Last Name

Place of Employment:

Address of Employment: Employer’s Telephone Number

(______)_______-__________

I authorize the release of this information and give permission to the Child Care Information Services (CCIS) agency to verify all information contained in this form.

X________________________________________________________________________________________ __________________________________________ Employee’s Signature Date

THIS SECTION MUST BE COMPLETED BY THE EMPLOYER Employer Identification Number (EIN): EMPLOYEE INFORMATION: Employee’s Job Title: Is the above-mentioned employee newly hired: Yes No Employment Start Date: ______/_______/______

EMPLOYMENT INCOME: HOURLY RATE: $

AVERAGE DAILY TIPS: $

GROSS PAY: $

NEXT PAY DATE:

____/_____/_____

FREQUENCY OF PAY: Weekly Bi-Weekly (26 pays/year) Twice a Month (24 pays/year) Monthly

THE EMPLOYEE: Receives pay stubs Does not receive pay stubs Receives pay in CASH Has access to pay information online via the following website: _________________

EMPLOYMENT SCHEDULE (Please indicate the days and hours the employee works and indicate whether the hours occur during A.M. or P.M) NOTE: If the schedule varies, please give a 4-week sample schedule. WEEK ONE Dates: from_______________ to_________________


TOTAL # HOURS/WEEK:____________________

WEEK TWO Dates: from_______________ to_________________


TOTAL # HOURS/WEEK:____________________

WEEK THREE Dates: from____________ to_______________


TOTAL # HOURS/WEEK:____________________

WEEK FOUR Dates: from______________ to________________


TOTAL # HOURS/WEEK:____________________

Effective Begin Date of Schedule change: _____/_____/_______

EXTENDED LEAVE Is the employee on extended leave (maternity, disability, etc.)? Yes No Effective begin date of extended leave: _____/_____/_____ Date returned from extended leave:____/____/____ TEMPORARY/SEASONAL EMPLOYMENT Is the employee considered to be a temporary hire? Yes No If the employee is considered a temporary hire, what is the last date of guaranteed employment? ______/______/_______

If the employee is seasonal, please give: Last day of work before break:______/_______/_______ Expected date of return following break: _________/________/_________

I understand that the information I am providing will be used to determine the above-named employee’s eligibility for subsidized child care. X _____________________________________________________________________________________________________ ________________________________________ Employer’s Signature Date

Please Print your name:_______________________________________________________________________ Job Title:___________________________________________________________

Employment Verification Form for:

EVF 2/2015

Dear Employer: One of your employees has requested assistance paying his/her child care costs. We must verify his/her employment with you. This information will help us determine if this employee us eligible for the subsidized child care program. The form can be returned to the employee or mailed directly to the Child Care Information Services (CCIS) agency.

We must have an accurate record of your employee’s work schedule. Please complete the information on the back of this page. It is very important that the hours shown are specific and defined as either A.M. or P.M. (For example, 7:30 a.m. – 3:30 p.m.). If the employee’s schedule varies, please give a 4-week sample schedule. You do not need to give a 4-week sample schedule unless the employee’s schedule varies from week to week. Thank you for your time and assistance. If you have any questions about how to complete this form, please contact the CCIS listed below.

Employee Verification Form

An authorized COMPANY REPRESENTATIVE (not the employee) must complete this form.

marmoy

CCIS

12/10/10 CCIS R039 Things you need to know

THINGS YOU NEED TO KNOW ABOUT

SELECTING A CHILD CARE PROVIDER Pennsylvania’s Subsidized Child Day Care System is a parent choice system. It is your responsibility to

select the type of child care that is most appropriate for your child and best meets the needs of your family.

If your family is determined eligible for subsidy, you may choose an eligible child care provider from any of

the types listed below. Any child care provider you choose must enter into a Provider Agreement with

Child Care Information Services (CCIS) of Berks County. It is your responsibility to pay your provider the

full cost of care until we meet with you face-to-face, and set a start date for your funding.

Types of Child Care: Day Care Center

a program that cares for 7 or more children unrelated to the day care operator

must have a Certificate of Compliance from the Department of Public Welfare

Group Day Care Home

a program that cares for between 7 and 12 children unrelated to the day care operator

must have a Certificate of Compliance from the Department of Public Welfare

Family Day Care Home

a program with 1 caregiver who cares for between 4 and 6 children unrelated to the caregiver

must have a Certificate of Registration from the Department of Public Welfare

Relative/Neighbor Care

a person caring for no more than 3 children, who are not their own, in his or her home

must meet the following requirements, among others:

be 18 years of age or older

be able to provide photo ID

be able to provide proof of social security number

be able to provide proof of physical address

be able to provide proof of phone

have a Federal Criminal History Clearance

fingerprinting requirement (fee charged)

allow the CCIS to submit a child abuse clearance and criminal background check (fee

charged)

be able to meet face-to-face with CCIS staff

In-Home Care

a caregiver comes to your home to care for your child

If you choose this type of care, you become the employer of your caregiver with all of the

responsibilities of an employer. This option is only available in certain situations.

If you have any questions about your child care options, or if you need

help finding a child care provider, please call our office at

610-987-CCIS-(2247).

9/17/10 CCIS R101 Family Comp.

Dear Parent/Caretaker, Based on a condition of eligibility for subsidized child care, you must verify your family’s size and composition. Please submit ONE of the following for all family members listed on your application and send to us along with the application, all income verification, proof of address, employment and/or training verification, and the Authorization for Information sheet:

Note: You do not have to submit all of the items listed for each family member.

o Custody Orders o Medical records or written statement from a physician* o Copies of birth certificates o School records** o Written statement from your landlord or clergy

If you are unable to submit any of the above, contact the Intake Specialists:

Kristin Blue – 610-987-8616 Elizabeth Koczot – 610-987-8619

* A medical record or statement from a physician must show that the address they have for the children matches the address you reported on the application. ** A school record must show that the address they have for the children matches the address you reported on the application.

A Department of Public Welfare Certificate of Compliance

for Centers or registration for Family Day Care Homes

A comfortable place where your child can explore and learn

Laughing, reading, and talking to build language skills

Teachers learning new ways to help your child succeed

A safe, healthy and exciting place

Music, art, science, and play activities that increase school

readiness

Your child feeling good about him/her self

Lots of family involvement

Teachers that listen to children and parents

Children having fun together and being respectful

Keystone STARS is a quality rating system. It has four STAR levels as noted in the chart below. Each STAR designation has its own research-based performance standards. As a facility moves from STAR One to STAR Four, the requirements in these areas

increase. The chart below gives examples of the requirements each facility must meet at each STAR level.

In A One STAR Facility you

will find:

In A Two STAR Facility you

will find:

In A Three STAR Facility you will

find:

In A Four STAR Facility you will

find:

A full DPW Child Care

Certificate of Compliance or

Registration for a year

A plan to increase early care and education

professional development

and training for the staff

Increased staff

communication by team meetings

A completed self-

assessment on quality

items in the environment

Director and Staff must

receive at least 3 to 6

hours more annual

professional development and training than DPW

regulations require

One third of the staff

completed or are enrolled

in credentials or degrees Learning materials such as

books, blocks, puzzles,

music and art supplies are

available for some of the

day The facility has a budget

and provides at least one

benefit to staff

Some involvement of

parents in the program

A plan to address needs found in a standardized

self-assessment of the

program

Even more professional

development and training

hours than STAR Two

requires One half of the staff

completed or are enrolled in

credentials or degrees

Learning materials available

for a large part of the day Literacy activities including

reading to children, story

telling and encouraging

written and verbal

communication happen often during the day

Increased parental

involvement

Written policies and

procedures

Implementation of a financial system, increased staff

compensation and benefits

A review of the facility by a

nationally recognized

environmental rating scale that indicates a minimal

quality score

Even more professional

development and training

hours than STAR Three requires.

Two thirds of the staff

completed or are enrolled in credentials or degrees

Activities designed to

encourage communication,

both written and verbal, occur naturally in the day

Parental and community

resources used effectively in the delivery of quality child

care

Business, organizational and staff compensation practices

are maximized

A review of the facility by a nationally recognized

environmental rating scale

that indicates a high quality score

The Child Care Information Services Agency (CCIS) is not endorsing or recommending any particular child care provider. Every parent/caretaker should review provider information and visit a provider to decide what is best for your child. This flyer is solely informational.

CASE IDENTIFICATION

COUNTY CCMIS RECORD NUMBER

COMMONWEALTH OF PENNSYLVANIA

DEPARTMENT OF PUBLIC WELFARE

AUTHORIZATION FOR RELEASEOF INFORMATION

NAME

ADDRESS ZIP CODE

I hereby authorize and request the disclosure to the Child Care Information Services (CCIS)agency to contact reliable sources for knowledge of information pertinent to verification of:identity; residence; employment; education and training activities; family size and composition; care and control of child(ren) residing with a grandparent, aunt or uncle; reasons for subsidy suspension; income; and any additional information pertinent to eligibility for the Subsidized Child Care Program for myself and/or those individuals on whose behalf subsidy benefits are paid. I understand that the information obtained will beused only for purposes directly related to the determination of eligibility for the SubsidizedChild Care Program.

ORIGINAL CASE RECORD FILE CY 880 11/06

PARENT/CARETAKER SIGNATURE

PARENT/CARETAKER SIGNATURE

CCIS REPRESENTATIVE SIGNATURE

DATE

DATE

DATE

CY 0880.qxp 11/9/2006 1:16 PM Page 1

STOP!! IF YOU ARE CURRENTLY RECEIVING CASH

ASSISTANCE OR IF YOU HAVE RECEIVED CASH

ASSISTANCE IN THE LAST 183 DAYS, CONTACT OUR OFFICE BEFORE FILLING OUT

THIS APPLICATION.

DID YOU REMEMBER TO:FILL IN ALL AREAS OF THE APPLICATION?

PROVIDE COPY OF BIRTH CERTIFICATES FOR

EVERYONE WHO LIVES WITH YOU?

ENCLOSE EMPLOYMENT VERIFICATION FORM

FOR YOU AND SPOUSE OR LIVE-IN FATHER OF

CHILD(REN)?

ENCLOSE THE LAST 4 WEEKS WORTH OF PAY STUBS

FOR YOU AND SPOUSE OR LIVE-IN FATHER OF

CHILD(REN)?

ENCLOSE PROOF OF ANY OTHER INCOME SUCH

AS SSI, CHILD SUPPORT, UNEMPLOYMENT?

ENCLOSE PROOF OF ADDRESS?

SIGN IMMUNIZATION CERTIFICATE ON PAGE 4?

SIGN AFFIDAVIT ON PAGE 6?

FILL IN, SIGN AND DATE THE AUTHORIZATION FOR

INFORMATION?

IF YOU HAVE QUESTIONS, READ PAGE 3 OR

CALL OUR OFFICE AT (610) 987-CCIS (2247).

Pennsylvania Department of Public Welfare

A PARTNERSHIP OF CARING

A Parent’s Handbook to Subsidized Child Care

Pennsylvania Department of Public WelfareOffice of Child Development

In partnership with Child Care Information Services

A PARTNERSHIP OF CARING

M E E T I N G T H E N E E D S O F C H I L D R E N A N D FA M I L I E S I N A C A R I N G W AY

TA B L E O F C O N T E N T S

A Letter to Parent/Caretakers ....................................................................Page 4Questions & Answers about Subsidized Child Care

I need help finding and paying for child care. Pages 5-8

1. What is subsidized child care?........................................................................52. What is the Child Care Information Services (CCIS)? ......................................53. What are the guidelines for the subsidized child care program?................5-64. How do I show that I meet the guidelines? ....................................................65. What if I have a special case? ......................................................................76. When will my subsidized child care begin? ....................................................77. When my TANF cash ends can I get subsidized child care? ..........................8

Now that I meet the guidelines - What do I need to know? Pages 9-12

1. Will I have to help pay for my child care?......................................................92. How can I get help finding child care? ..........................................................93. What types of child care programs are there? ........................................9-104. What if my information changes? ................................................................115. What if I lose my job or become disabled? ................................................116. What if I move to a new county? ................................................................127. How often will the CCIS review my case? ....................................................12

What are my rights and responsibilities in the subsidized child care program? Pages 13-14

Helpful Hints ............................................................................................Page 14Who can I call with more questions? ......................................................Page 15

3

Commonwealth of pennsylvania

Department of Public Welfare

Office of Child Development

P.O. Box 2675

Harrisburg, Pennsylvania 17105-2675

Dear Parent/Caretaker:

We welcome you to Pennsylvania's subsidized child care program, a partnershipbetween parents, providers, the Child Care Information Services (CCIS) and the Officeof Child Development.

The children of Pennsylvania are the keys to tomorrow. We prepare our children during the early years so that they are ready for each stage of learning.

Each county in Pennsylvania has a CCIS Office. The staff members are trained tohelp you as you make your child care decisions. Your county's CCIS office is listedon the back of this handbook.

We hope that this Parent Handbook will answer your questions about subsidized child care. We look forward to working with you and your family.

Harriet Dichter,Deputy SecretaryOffice of Child Development

4

1. What is subsidized child care?

This is called a subsidy payment.This is called the family co-pay.

subsidy payment family co-pay

Note: If your child care subsidy does not pay the full amount that your child careprogram charges, the provider may ask you to pay the difference between thesubsidy payment and their private charges.

2. What is the Child Care Information Services (CCIS)?

The CCIS will:

3. What are the guidelines for the subsidized child care program?

The following are the basic guidelines:

I need help finding and paying for child care.

1. What is subsidized child care?

The subsidized child care program helps low-income families pay their child care fees. The state and federal governments fund this program, which is managed by the Child Care Information Services (CCIS)located in your county.

If you meet the guidelines:• The CCIS will pay a part of your child care fee. This is called a subsidy payment.• You will pay a part of the fee. This is called the family co-pay.• The subsidy payment and the family co-pay go directly to the child care program.

Note: If your child care subsidy does not pay the full amount that your child careprogram charges, the provider may ask you to pay the difference between thesubsidy payment and their private charges.

2. What is the Child Care Information Services (CCIS)?

The Child Care Information Services (CCIS) office is the center for child care information and child carehelp in your county. You can call or visit the CCIS office for a subsidized child care application.

The CCIS will:• Review your application to see if you meet the guidelines for the subsidized child care program.• Help you find a child care program. • Provide information and ideas about how to select the best possible early learning program or setting

for your child

3. What are the guidelines for the subsidized child care program?

You must submit an application to the CCIS office to see if you meet the guidelines for the subsidized childcare program.

The following are the basic guidelines:• You must live in Pennsylvania• Have a child or children who need child care while you work or attend an education program• Meet income guidelines for your family size• Work 20 or more hours a week -or-• Work 10 hours and train 10 hours a week• Have a promise of a job that will start within 30 days of your application for subsidized child care• Teen parents must attend an education program

5

6

• The child who needs care must be a citizen of the United States or an alien lawfully admitted for permanent residency

• Have proof of identification for each parent or caretaker in the home.

44.. HHooww ddoo II sshhooww tthhaatt II mmeeeett tthhee gguuiiddeelliinneess??

You must submit a subsidized child care application to the CCIS.

You may call the CCIS in your county to request an application. The CCIS will mail the application to you.You can also visit the CCIS to pick up an application.

MMaakkee ssuurree tthhaatt yyoouu rreeaadd tthhee ddiirreeccttiioonnss oonn tthhee aapppplliiccaattiioonn ccaarreeffuullllyy.. If you have any questions call theCCIS. Complete all sections of the application and make sure that you sign and date the applicationbefore you return it to the CCIS. You may file your application in person, by mail or fax.

NNoottee:: Certain items needed to see if you meet the subsidized child care guidelines are based on yourword, and some require outside proof.

IIff yyoouu aarree hhaavviinngg pprroobblleemmss getting the needed information let the CCIS know right away. The CCIS will helpyou get the information you are unable to obtain.

The CCIS will ask you to sign a consent form so that they can help you get the needed information.

TThhee iinnffoorrmmaattiioonn yyoouu pprroovviiddee wwiillll bbee kkeepptt ccoonnffiiddeennttiiaall.. TThhee iinnffoorrmmaattiioonn iinn yyoouurr ffiilleewwiillll bbee uusseedd ffoorr yyoouurr ppaarrttiicciippaattiioonn iinn tthhee ssuubbssiiddiizzeedd cchhiilldd ccaarree pprrooggrraamm..

• YYoouu mmaayy sseellff--cceerrttiiffyy iinnffoorrmmaattiioonn - this means the CCIS will accept a statement from the parent orcaretaker as proof of the following information:

(1) Age of Child(2) Citizenship or immigration status(3) Immunization status (shot records)(4) Days and hours that a child needs care (former TANF client)(5) Former TANF status (6) Extended time frame for a face-to-face meeting based on a hardship

• YYoouu mmaayy sseellff ddeeccllaarree iinnffoorrmmaattiioonn - this means you do not have to submit information right away. Youcan tell the CCIS the information that is needed. You will then have 30 days to submit the proof. Youwill need to sign a form given to you by the CCIS.

The CCIS will send you a notice to let you know if you meet the guidelines. Thisnotice is called a CChhiilldd CCaarree EElliiggiibbllee NNoottiiccee. if you do not meet the guidelines theCCIS will send you a notice called a CChhiilldd CCaarree IInneelliiggiibbllee NNoottiiccee.

5. What if I have a special case - can I get subsidized child care?

Disabled Child

Disabled Spouse

Domestic Violence

Shared Custody

Foster Parent

Head Start child

Pre-Kindergarten child

Please talk to your CCIS if you think you have a special case that is not listed.

6. When will my subsidized child care begin?

If funds are available

If funds are not available

7

5. What if I have a special case - can I get subsidized child care?

Maybe. The CCIS will let you know what you will need to submit for each special case.

The following are examples of special cases:• Disabled Child - If you have a child between the ages of 13 and 19 who is physically or emotionally

disabled and unable to care for himself, that child may be eligible for the subsidized child care program.

• Disabled Spouse - If you have a disabled spouse who cannot care for your children while you work,your family may still meet the guidelines for the subsidized child care program. Your spouse will needto submit proof from their doctor or licensed psychologist.

• Domestic Violence - if you are a victim of domestic violence you can request a waiver from theCCIS. A waiver means some of the guidelines will be delayed for a period of time. You will need tocomplete a form. The CCIS will never contact the person who is causing the domestic violence.

• Shared Custody - If you share custody of your child and you need child care while you work you maymeet the guidelines for the subsidized child care program. If you meet the guidelines, you willreceive subsidy on the days that you have your child.

• Foster Parent - If you have a foster child and you need child care while you work, submit a subsidizedchild care application to the CCIS along with a letter from the county's Children and Youth Agencyexplaining that you are a foster parent and that the foster child needs child care.

• Head Start child - If you have a child who is enrolled in a Head Start program and you need childcare to continue working submit proof of enrollment from the Head Start program.

• Pre-Kindergarten child - If you have a child attending a pre-kindergarten program that is certified bythe area school district and you need additional child care hours beyond the Pre-kindergarten program to continue working you will need to submit proof of enrollment from the school.

Please talk to your CCIS if you think you have a special case that is not listed.

6. When will my subsidized child care begin?

Once you meet the guidelines for the subsidized child care program, this is what will happen:

The CCIS will send you a Child Care Eligible Notice.

a) If funds are available you will need to do the following within 30 days:I. Meet with the CCIS worker for a face-to-face interviewII. Select a child care program that meets the Provider Standards of the Office of Child DevelopmentIII. Enroll your child in a child care program.

If funds are available, subsidized child care payments may begin from the datethat your application was received in the CCIS Office. The CCIS will let you knowthe start date of subsidized child care payments on the enrollment summary

b) If funds are not availableI. Your name will be placed on a waiting listII. The CCIS will send you a letter when subsidized funds are availableIII. When you receive the letter you will have 30 days to:

A. Meet with the CCIS worker for a face-to-face interviewB. Select a child care program which meets the Provider Standards of the Office of Child

DevelopmentC. Enroll your child in a child care program

“A partnership of caring - leads to

successful outcomes.”

7. When my TANF cash ends can I get subsidized child care?7. When my TANF cash ends can I get subsidized child care?

If you receive TANF cash benefits within the last 6 months and you have a child who needs care while youare working, you may meet the guidelines for continued subsidized child care.

The CCIS will send a letter to TANF families when their cash benefits end. The letter will let you know whatyou need to do to continue receiving subsidized child care or to begin receiving subsidized child care.

If you were getting child care assistance from the County Assistance Office (CAO) at the time your cashbenefits were closed, your case will be transferred to the CCIS office. This means your child care fundingwill continue from the date your cash closed.

If your TANF cash benefits were closed and you did not receive a letter from the CCIS and you need childcare, contact the CCIS office right away.

8

“A partnership of caring - leads to

successful outcomes.”

“We prep are ourchildren so that they are ready for each stage of learning.”

Now that I meet the guidelines - What do I need to know?

1. W ill I have to help pay for my child care?

9

1. Will I have to help pay for my child care?

Yes. All families in the subsidized child care program pay a family co-pay amount. The co-pay is basedon your family size and income. Your family co-pay will start on the first day that subsidized child care payments begin.

Important family co-pay information:

• Your family co-pay will not increase for a six month period.

• If your income decreases you can notify the CCIS. Your co-pay may be lowered based on the newinformation.

• Your first family co-pay must include one week and a deposit equal to the first co-pay amount.

• The family co-pay is due on the first day of each week.

22.. HHooww ccaann II ggeett hheellpp ffiinnddiinngg cchhiilldd ccaarree??

Call the CCIS office. A parent services staff will talk to you about child care options. You will get a list ofchild care programs that you can call or schedule an appointment to visit.

33.. WWhhaatt ttyyppeess ooff cchhiilldd ccaarree pprrooggrraammss aarree tthheerree??

There are over 9,000 certified child care programs in Pennsylvania. These include center, group and familyday care homes. The Office of Child Development inspects all certified centers and group day carehomes once a year. Unannounced visits are also made to those certified programs. A sample of regis-tered family day care homes are selected each year for an on-site inspection.

Each teacher, assistant teacher and aide in a certified or registered child care program must:

• meet educational guidelines

• participate in on-going professional development

• pass a criminal history and child abuse clearance,

• have a health assessment

“We prepare ourchildren so that theyare ready for eachstage of learning.”

Child care centers and group day care homes must have a Certificate of Compliance to operate inPennsylvania.

TThhee CCeerrttiiffiiccaattee ooff CCoommpplliiaannccee must be posted at the location. It will show the name and address of theprogram, the number of children they are allowed to care for and the expiration date of the certificate.

Family Day Care Homes must have a Certificate of Registration to operate in Pennsylvania.

TThhee CCeerrttiiffiiccaattee ooff RReeggiissttrraattiioonn must be posted in the home. It will show the name of the provider and theexpiration date of the registration. A Family Day Care program can only care for up to 6 children at onetime who are unrelated to the provider.

TThhee ffoolllloowwiinngg pprroovviiddeerr ttyyppeess aarree uunncceerrttiiffiieedd aanndd uunnrreeggiisstteerreedd.. To receive subsidized child care paymentsthese providers must pass a criminal history and child abuse clearance to care for your child.

TThhee uunncceerrttiiffiieedd uunnrreeggiisstteerreedd pprroovviiddeerrss iinncclluuddee::

• Relative/Neighbor Provider (R/N) A relative/neighbor provider can only care for up to 3 children at any one time.

• In-Home Provider This provider cares for your child in your home. You are considered the employer. You must pay thisprovider at least the minimum wage and pay all required federal and state taxes as an employer.

SSuubbssiiddiizzeedd cchhiilldd ccaarree ppaayymmeennttss ccaann oonnllyy bbee mmaaddee ttoo aann IInn--HHoommee pprroovviiddeerr uunnddeerr tthhee ffoolllloowwiinngg ssppeecciiaallccoonnddiittiioonnss::

• If you work between the hours of 9:00 pm and 6:00 am or

• If care outside the home is a risk to the child's health. (The child's health condition must be documented by a licensed physician or psychologist. The letter must also explain why the childneeds in-home care.)

10

Pennsylvania offers a special programcalled Keystone Stars to certified and registered providers. Keystone Stars is aquality improvement program that helpschild care providers develop and trainstaff to support a child's development,early learning and school readiness.

Providers who have a Keystone STARSrating have met additional quality standards established by the Departmentof Public Welfare.

CHANGES THAT MUST BE REPORTED WITHIN 10 DAYS OF THE CHANGE:

4. What if my information changes?

The CCIS will work with you whenever there are changes in your information.

5. What if I lose my job or become disabled?

If you lose your job

If you become disabled

You must submit:

Talk to the CCIS about your child care options when you go on Family leave, Disability or Maternity Leave.

Note for parent/caretakers on Maternity Leave

4. What if my information changes?

Call your CCIS office. Some changes must be reported within 10 days of the change, other changes arehelpful to report just in case the CCIS needs to contact you.

The CCIS will work with you whenever there are changes in your information.

CHANGES THAT MUST BE REPORTED WITHIN 10 DAYS OF THE CHANGE:

If you lose your job, Including a layoff or strike Your hours of work or training drop below 20 hours per week

Start of disability and the date you return to work Start of maternity, paternity or adoption leave and the date you return to work

A change in the days and hours child care is needed A change in family size

Change of Address

CHANGES THAT ARE HELPFUL TO REPORTCHANGES THAT ARE HELPFUL TO REPORT

A decrease in pay A new job

A new home telephone number A new job telephone number

5. What if I lose my job or become disabled?

If you lose your job, call the CCIS office right away. The CCIS will explain to you what you will need to do. If you were laid-off or fired from your job while receiving subsidized child care, funding will continue for upto 60 days, giving you time to find a new job. If you quit your job you will be given 13 days of continuedsubsidized child care funding.

If you become disabled while receiving subsidized child care and are unable to continue working call theCCIS office. If you are unable to care for your child during your disability, subsidized child care funding willcontinue up to six months from the date you stopped working. You must submit proof from your doctor orpsychologist. If you go on Family leave or Maternity leave subsidized child care may continue for 12 weeksfrom the date that your family or maternity leave started.

You must submit:• A letter from your employer or doctor which states the date family or maternity leave started.• Income information (Your family co-pay may be lowered based on the new information)

Talk to the CCIS about your child care options when you go on Family leave, Disability or Maternity Leave.• You may continue to send your child who is receiving care to the child care program -or-• You may suspend subsidy for up to 90 days or until you return to work within the 12 week period.

Note for parent/caretakers on Maternity Leave - Let the CCIS know if you will needchild care for your newborn. If funds are available care may begin once you returnto work. If funds are not available your newborn will be placed on the waiting listfrom the date of your request.

11

6. What if I move to a new county?6. What if I move to a new county?

If you move to a new county your subsidized child care funding will continue based on your new informa-tion. The CCIS will transfer your records to the CCIS office in the new county. You should let the CCIS knowbefore you move so that subsidized child care payments will continue. The CCIS in the new county willalso help you locate a new child care program.

77.. HHooww oofftteenn wwiillll tthhee CCCCIISS rreevviieeww mmyy ccaassee??

Once Once you you complete complete your your application application and and meet meet the the guidelines guidelines for for the the subsidized subsidized child child care care program program thetheCCCCIISS wwiillll rreevviieeww yyoouurr ccaassee eevveerryy 66 mmoonntthhss.. This process is called a redetermination of eligibility.

A rreeddeetteerrmmiinnaattiioonn means the CCIS will review your family income, work and training status and your contin-ued need for subsidized child care. You must provide up-to-date proof of your family's earned income ateach redetermination.

You will not need to provide any other proof unless there has been:• A change in unearned income received by your family• A drop in your hours of work, education or training below an average of 20 hours per week• A new job• A change in your family size

TThhee CCCCIISS wwiillll mmaaiill aa RReeddeetteerrmmiinnaattiioonn SSuummmmaarryy ttoo yyoouurr hhoommee aaddddrreessss.. IItt wwiilllliinncclluuddee tthhee ddaattee tthhaatt yyoouu wwiillll nneeeedd ttoo ssuubbmmiitt yyoouurr uupp--ttoo--ddaattee iinnffoorrmmaattiioonn.. yyoouu mmaayyffaaxx,, mmaaiill oorr bbrriinngg yyoouurr iinnffoorrmmaattiioonn ttoo tthhee CCCCIISS ooffffiiccee..

12

Parent/Caretaker Rights:You have the right to be treated fairly and with respect

1. You have the right not to be discriminated against.

2. You have the right to examine your file.

3. You have the right to a timely decision.

Missing information letter submit.

4. You have a right to a written notice.

5. You have the right to appeal any decision or action made by the CCIS.

6. You have the right to have your subsidy continue pending a hearing

Notice of Adverse Action

The Notice of Adverse Action lists:

What are my rights and responsibilities in the subsidized child care program?

Parent/Caretaker Rights:You have the right to be treated fairly and with respect

1. You have the right not to be discriminated against. You and your family may not be discriminatedagainst in the subsidized child care program on the basis of age, race, sex, color, religious creed,national or ethnic origin, ancestry, sexual preference or physical or mental disability

2. You have the right to examine your file. The family file contains information that is used to determineyour eligibility for the subsidized child care program. A parent/caretaker or his/her representative, or aperson who was given permission by the parent/caretaker has a right to examine his or her file in theCCIS office.

3. You have the right to a timely decision. You have the right to file your signed application on any daythat the CCIS office is open for business. The CCIS will review your application right away to make surethat you have all of the needed documents.

If information is missing you will receive a Missing information letter telling you what you need to submit

4. You have a right to a written notice. You have the right to receive a written notice from the CCIS officewhenever a decision is made that affects your eligibility for the subsidized child care program. Thisincludes decisions denying subsidy, terminating subsidy, setting or changing co-payments, denying adomestic violence waiver, suspending or disrupting subsidy.

There are several types of notices:

• Child Care Eligible Notice• Child Care Ineligible Notice• Child Care Confirmation Notice

• Notice of Adverse Action• Notice of Overpayment• Notice Confirming Voluntary Withdrawal

5. You have the right to appeal any decision or action made by the CCIS. You have the right to appealany decision, action or failure to act by the CCIS office that affects your family's eligibility for the subsi-dized child care program. This includes denial of subsidy, termination of subsidy, computation of theco-payment, denial of a domestic violence waiver, failure of the CCIS agency to act upon a requestfor subsidy within the required time limits, or suspension or disruption of subsidy.

6. You have the right to have your subsidy continue pending a hearing whenever you get a Notice ofAdverse Action proposing to terminate your subsidized child care.

A Notice of Adverse Action is the type of notice that is used if the CCIS plans to end (terminate) or sus-pend your subsidy. The Notice of Adverse Action lists:

• The proposed date that subsidized funding will end

• The regulation that you have failed to meet

• How to file an appeal

• The deadline date to file your appeal

• The address and telephone number of the County Legal Services Office.

The CCIS must make a determination of eligibility within 10 days of the date that all requiredinformation is received.

The CCIS may not delay a decision on your application beyond 30 days from the date yourcompleted application was received.

13

Note:

7. You have the right to choose care from any provider who agrees

Each provider must sign a provider agreement

8. You have the right to view the Rules and Regulations for subsidized child care.

Parent/Caretaker Responsibilities:

1. Submit true information to the CCIS.2. Report changes in a timely manner.3. Pay your family co-pay on time

Helpful HintsAttend Your child should attend

Note: If you appeal within 10 days of the date of the Notice of Adverse Action, you may continue toreceive subsidized child care until your appeal is decided.

If subsidized funding continues during the appeal and the appeal is decided in favor of the CCIS, youwill have to pay back the amount of the subsidy that you received during the appeal, unless the hear-ing officer determines that paying the amount back would create a hardship for your family.

7. You have the right to choose care from any provider who agrees to abide by the Provider Standards ofthe Office of Child Development.Each provider must sign a provider agreement before the CCIS will subsidize the child care cost at theirsite. The CCIS will notify the provider to let them know when subsidized child care payments will begin.

8. You have the right to view the Rules and Regulations for subsidized child re. The rules and regula-tions for subsidized child care eligibility can be viewed and printed from the internet. If you do nothave a computer you can get a copy of the regulations from your CCIS office.

1. Go to www.pacode.com

2. Click on Browse (a menu will appear)

3. Select 55-Public Welfare

4. Scroll down to Chapter 3041 - Subsidized Child Care Eligibility

Title 55 - Public WelfareDEPARTMENT OF PUBLIC WELFARE

[55 PA.CODE CHAPTER 3041]Subsidized Child Care Eligibility

Parent/Caretaker Responsibilities:

As a parent/caretaker who receives subsidized child care the following are your most important responsibilities:

1. Submit true information to the CCIS.2. Report changes in a timely manner.3. Pay your family co-pay on time.

Helpful HintsAttend Your child should attend the child care program on all days assigned. If your child is absent or ill,

please call your provider.

CCaallll CCaallll yyoouurr CCCCIISS ooffffiiccee if you have any questions.

CChhaannggeess IIff tthheerree aarree cchhaannggeess that may affect your child care needs call the CCIS office.

PPaayy AAllwwaayyss ppaayy your family co-pay on time.

RReeaadd RReeaadd aallll iinnffoorrmmaattiioonn tthhaatt yyoouu rreecceeiivvee from the CCIS office. If you do not understand or have questions call the CCIS.

SSaavvee SSaavvee yyoouurr ppaayy ssttuubbss or the information that you get showing how much money you earn monthly.This will help you when it is time to show proof of income earned.

TTeellll TTeellll yyoouurr ffrriieennddss about the subsidized child care program.

TTrraannssffeerr IIff yyoouu wwaanntt ttoo ttrraannssffeerr to a new child care program call the CCIS.

14

More Questions ...Who can I call if I have child care concerns?

CCIS Concerns

Subsidized ChildCare Concerns

Legal Services

Provider Concerns

Keystone Stars

Important Telephone Numbers ...

OFFICE REGION TOLL FREE NUMBER

Central Region 1-800-222-2117Office of ChildDevelopment Northeast Region 1-800-222-2108

Southeast Region 1-800-346-2929

Western Region 1-800-222-2149

Legal Services Statewide 1-800-322-7572

CCIS Office Listed on the back of this handbook

More Questions ...Who can I call if I have child care concerns?

CCIS Concerns If you have questions about child care subsidy, call your CCIS. If you are not satisfied, askto speak to a supervisor. Your CCIS number is listed on the back of this handbook.

Subsidized Child Call the Regional Office of Child Development. The numbers are listed below.Care Concerns

Legal Services If you need help with an appeal, a fair hearing or you need legal advice about your eligibility for subsidized child care call the legal services office. The number is listed on theback of this handbook.

Provider Concerns If you think something is wrong with your child care program or if you see mistreatment of achild, call the Regional Office of Child Development. The number is listed below.

Keystone Stars If you would like to locate a Keystone STARS provider in your area, call your CCIS. The CCISnumber is listed on the back of this handbook.

Important Telephone Numbers ...

15

OFFICE REGION TOLL FREE NUMBER

Office of ChildDevelopment

Central Region 1-800-222-2117

Northeast Region 1-800-222-2108

Southeast Region 1-800-346-2929

Western Region 1-800-222-2149

Legal Services Statewide 1-800-322-7572

CCIS Office Listed on the back of this handbook

“The childrenof Pennsylvania

are the keysto tomorrow.”

“The childrenof Pennsylvania

are the keysto tomorrow.”

Pub 549 3/06

CCIS Office

This program is made possible by the

For Legal Services call:1-800-322-7572

The Web address is:www.palegalservices.org

w w w. d p w. s t a t e . p a . u s

Edward G. Rendell Estelle B. RichmanGovernor Secretary

vicbae

CCIS label

Dear Child Care Provider,

The Department of Public Welfare has made changes to the subsidized child care

regulations that could affect your subsidized child care payment. These changes will

take effect on July 1, 2012. Below is an explanation of the changes that could affect you.

Co-payment for a School-Age Child

A family that receives part-time subsidized child care for only one child who is

enrolled in school, will now be required to pay the full co-payment amount. In some

cases families may not remain eligible for subsidized child care through the school

year, when part-time care is needed, because the co-payment will exceed the cost of

care.

Consecutive Days of Absences

If a child is absent from child care for five consecutive days, the child will become

ineligible for subsidized child care and the Child Care Information Services (CCIS)

agency will send an Adverse Action notice to the p/c. If the child does not return to

child care within the 13 days covered by the notice, subsidized child care will end.

The provider will only be paid for up to five consecutive days of absence before

payment is suspended.

Absences at the Start of Scheduled Care

If a child is absent on the first day of scheduled care, payment will begin on the first

day the child attends. If the child attends on any day the first week, the

parent/caretaker (p/c) is required to pay the co-payment for that week.

Limit on Number of Paid Absences

The CCIS will only pay for a maximum of 25 absences, for each child, during the

State’s fiscal year. The State Fiscal Year begins on July 1st of one year and ends June

30th

of the following year. If a child has more than 25 absences from child care, the

p/c is required to pay the provider the provider’s daily rate for each day of absence

starting with the 26th

absence, in addition to the weekly co-payment. Suspended

days are not considered days of absence. The provider must collect payment for

absent days from the parent/caretaker.

Suspected Provider Fraud

The CCIS will refer ALL cases of suspected provider fraud to the Office of Inspector

General. Examples of provider fraud include, but are not limited to, failure to

indicate absences on the attendance schedule, failure to report consecutive absences

as specified in the Provider Agreement, receiving payment for a child who is not

enrolled or charging the Commonwealth a higher rate than private pay families.

Relative/Neighbor (R/N) Provider Rate Changes

R/N rates are paid based on the county where the R/N lives or the location of the

child, for In-Home Care or Out-of-State R/N providers. Full-time R/N rates in

counties that pay above $11.00 per day will be reduced by 15% or to $11.00

whichever is higher. Part-time rates in counties that pay above $7.75 will be reduced

by 15% or to $7.75 whichever is higher.

EXAMPLE: If an R/N provider is being paid $15.00 per day for full-time care, the

rate will be reduced by 15% to $12.75 per day. If an R/N provider is

being paid $12.00 per day for full-time care, the rate will only be

reduced to $11.00 per day.

Important Reminders for Providers

Providers must:

Accurately indicate all absences for each child on the invoice each month.

Notify the CCIS on the sixth day if a child is absent five consecutive days.

Submit invoices timely every month.

The Provider Agreement will be updated for 2012-2013 to reflect the changes and

new requirements for providers described above.

R/N providers affected by the rate change will receive a new Appendix B.

Regulated, in-state providers are encouraged to sign-up to use Online Attendance

Tracking (OAT). The use of OAT aides in timely receipt of invoices. To register for

OAT, go to www.PELICAN.state.pa.us/provider. Create an account and complete

the Provider Self-Service online registration. After your request is reviewed and

approved, you will be able to access a training simulation specifically designed for

providers.

If you have questions about these changes, please contact your local CCIS. Thank you

for participating in the Subsidized Child Care program.

Thank you.

http://www.pelican.state.pa.us/provider

Date discussed with P/C on _____/_____/______ Initials of Worker ___________ 11 CY 868 7/12

RIGHTS & RESPONSIBILITIES FORM For Low-Income /Former TANF / Head Start Cases

I understand that:

1. The information in this form will be kept confidential.

2. I may pick any eligible provider to care for my children. An eligible provider meets the requirements of the Subsidized Child Care Program and agrees to follow the

Department of Public Welfare’s rules.

3. I may need to pick another provider if my provider is not eligible to participate in the Subsidized Child Care Program.

4. I will be told in writing when a change causes my family to lose help in paying for child care and may ask for a hearing if I disagree with a decision that the CCIS has made.

5. I must give the CCIS agency true and complete information and proof of information as requested.

6. I must report the following to the CCIS agency within 10 days of the change:

● Loss of work including layoffs or strikes ● Telephone ● Who is providing child care for my child(ren)

● Decrease in hours of work, education or training below an average of 20 hours a week ● Address ● Number of days or hours my child needs care

● Number of people who live in the house with the child(ren) ● Marital Status ● Maternity leave status

7. I must pay back the cost of any child care I receive during a period of time when I am not eligible.

1. You must pay a co-payment to your provider every week. The co-payment is due to the provider on the first day of the week that your child(ren) attend(s). It is important

that you pay your co-payment on time. If you do not pay your co-payment on time, you may lose the CCIS agency’s help in paying for your child care.

2. Unless your child is ill, your child must attend the child care program on all the days that you told the CCIS he/she needed child care. If you need to make a change due to

your work, education or training schedule, you must call the CCIS. You could lose the CCIS agency’s help in paying for your child care costs if your child is absent for

5 days in a row for a reason other than: (1) Illness, injury or hospitalization of the child or another family member; (2) Family/maternity leave; (3) Visitation with a parent

who does not live with the child(ren) or (4) A break in your work, education or training.

3. If your child is absent for more than 25 enrollment days in the State’s fiscal year (July 1st – June 30

th), you will be responsible to pay the provider the daily rate for each day

of absence beginning with the 26th

absence. You must pay the provider’s daily rate in addition to your weekly co-payment. For example, if your co-payment is $20/week

and the daily rate is $20, you must pay $40 for the week that includes your child’s 26th

day of absence.

4. The CCIS will pay a child care center, family child care home or a group child care home for up to 15 days when the facility is not open to care for your child. The CCIS

is unable to pay an alternate child care provider during these 15 days when your provider is not open to care for your child.

5. If the CCIS sends you a Notice of Adverse Action, it means there may be a change in your eligibility for subsidized child care. If you do not understand what is written in

the notice, you should contact the CCIS agency immediately. If you disagree with a decision that the CCIS agency has made, you may ask for a hearing to review the

decision. You must inform the CCIS that you do not agree with the decision by doing one of the following: (1) Fill out the bottom part of your notice or write a letter and

then mail, fax or take the information to the CCIS; and (2) Call the CCIS to discuss the reason you do not agree with the decision and follow-up by putting your concerns in

writing within 7 days following the date of your telephone call with the CCIS. If you want the CCIS to continue to help pay for your child care during this process, you

must mail, fax or take the bottom part of your notice or the letter that you wrote to the CCIS or call the CCIS on or before the date on the Notice of Adverse Action.

6. You may choose a new provider at any time. However, you must tell the CCIS agency before your child begins child care with a different provider. The CCIS agency will

authorize the transfer and continue to help pay for your child care after the transfer if: your family co-payments are up-to-date AND you continue to be eligible for the CCIS

agency’s help in paying for your child care AND the new provider that you choose meets the requirements of the Subsidized Child Care Program. The new provider must

also agree to follow the Department of Public Welfare’s rules. If the CCIS does not authorize the transfer, you will be responsible for paying the total cost of child care at

the new provider.

After the CCIS has determined you eligible for child care and funds are available to enroll your child(ren) in care, you need to know the following:

D

E T

A

C H

A N

D

K

E

E P

F O

R

Y

O

U R

R

E

C O

R

D

S

Documents

FREQUENCY OF PAY: Weekly Bi-Weekly (26 pays/year) Twice a Month (24 pays/year) Monthly THE EMPLOYEE: Receives pay stubs Does not receive pay stubs Receives pay in CASH Has access