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Get the free ACF - 801 Child Care Monthly Case Record Form - acf hhs

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This document outlines the data collection requirements for families receiving subsidized child care assistance, including details on income, demographics, and provider information.
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How to fill out ACF - 801 Child Care Monthly Case Record Form

01
Obtain the ACF - 801 form from the official website or local agency.
02
Fill in the month and year for which you are reporting.
03
Enter the child's name and identification number.
04
Provide the address of the child’s residence.
05
Indicate the provider's name and address.
06
Record the days of service provided during the month.
07
Document the total hours of care for each day.
08
Include the parent's co-payment if applicable.
09
Calculate the total amount billed for the month.
10
Review all entries for accuracy before submission.
11
Submit the completed form to the appropriate authority by the deadline.

Who needs ACF - 801 Child Care Monthly Case Record Form?

01
Parents or guardians applying for child care assistance.
02
Child care providers seeking reimbursement for services.
03
State and local agencies managing child care programs.
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The ACF - 801 Child Care Monthly Case Record Form is a document used by child care providers to report monthly attendance, enrollment, and other relevant information for children participating in subsidized child care programs.
Child care providers who receive funding from the Child Care Development Fund (CCDF) or similar state and federal programs are required to file the ACF - 801 form.
To fill out the ACF - 801 form, providers must provide information such as the child’s name, enrollment status, attendance details, and any relevant fees or payments made for child care services.
The purpose of the ACF - 801 Child Care Monthly Case Record Form is to track and report participation in child care programs, ensuring proper allocation of funding and compliance with federal and state regulations.
The form must report information such as the child’s name, date of birth, enrollment dates, attendance records, payments received, and other relevant details of child care services provided.
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