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ES1652 Rev. 0107 Income Child Care Request Please complete this packet and return it to Return by:. This packet will help SRS determine your eligibility for Income child care subsidy. For Agency Use
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How to fill out in-home child care request

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How to fill out an in-home child care request:

01
Start by gathering all the necessary information. This will include your personal details, such as name, address, and contact information, as well as information about your child, such as their name, age, and any specific needs or requirements they may have.
02
Next, provide details about the type of care you are looking for. Include your preferred schedule, the number of hours required, and any specific tasks or responsibilities you would like the caregiver to handle.
03
Make sure to include any important information about your home and its surroundings. This may include details about pets, the layout of the house, and any safety concerns or precautions that need to be taken.
04
If you have any specific preferences or requirements for the caregiver, be sure to include those as well. This may include qualifications, experience, and any special skills or certifications you are looking for in a caregiver.
05
Finally, provide any additional information or instructions that may be relevant. This could include details about transportation, meal preparation, or any other specific needs or preferences you have for your child's care.

Who needs an in-home child care request:

01
Parents or guardians who are unable to provide full-time care for their children due to work or other commitments may need to submit an in-home child care request.
02
Families who prefer the convenience and personalized care that comes with having a caregiver come to their own home may also require an in-home child care request.
03
Children with special needs or medical conditions that require more individualized care may benefit from having a caregiver provide in-home child care.
Remember, when filling out an in-home child care request, it's important to be thorough and clear in expressing your needs and expectations. This will help ensure that you find the best caregiver for your child and that they have all the necessary information to provide safe and effective care.
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In-home child care request is a formal application for in-home child care services.
Parents or legal guardians who need in-home child care services are required to file the request.
To fill out an in-home child care request, you need to provide information about the child, the desired schedule, and any specific requirements or preferences.
The purpose of an in-home child care request is to request in-home child care services for a child.
The information required on an in-home child care request typically includes the child's name, age, any medical conditions or allergies, preferred schedule, and contact information for the parent or legal guardian.
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