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Child and Adult Care Food Program Adult Day Care Income Eligibility Form (IEF) 20162017 Part 1 Write your name and age. Please indicate your race and ethnicity. If this information is left blank,
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Individuals or organizations that provide child and adult care services are required to file for licensing and certification.
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Information such as the age range of children or adults served, staff-to-client ratios, safety procedures, and emergency protocols must be reported on child and adult care forms.
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