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CC-221-PD (9-11) ARIZONA DEPARTMENT OF ECONOMIC SECURITY Child Care Administration FAMILY CHILD CARE PROVIDER STATEMENT OF SERVICES NAME (Last, First, M.I.) DATE BUSINESS INFORMATION DAYS AND HOURS
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How to fill out family child care provider:

01
Gather all necessary personal information, including full name, address, and contact details.
02
Provide information about your experience in providing child care, including the number of years and any relevant certifications or licenses.
03
Outline the services you offer, such as the age range of children you can care for, the hours of operation, and any specialized programs or activities you provide.
04
Describe your home environment, including the safety measures in place, the availability of outdoor space, and any pets or allergens that may be present.
05
Detail your policies and procedures, such as your discipline methods, sick child policy, and any required paperwork or contracts.
06
Provide references from previous families you have worked with, including contact information for individuals who can vouch for your experience and reliability.

Who needs a family child care provider:

01
Working parents who require reliable and safe child care for their children while they are at work.
02
Parents who prefer a smaller, more intimate child care setting compared to larger daycare centers.
03
Families who are seeking personalized and individualized care for their children, with a focus on building relationships and meeting specific needs and preferences.
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A family child care provider refers to an individual or household that offers child care services in their home for a small group of children, typically including those of different ages.
Family child care providers are required to file if they meet certain criteria set by the relevant child care regulatory agency or government body in their jurisdiction.
The process of filling out a family child care provider may vary depending on the jurisdiction. Typically, providers need to complete an application form, provide documentation such as background checks and certifications, and submit it to the relevant agency or body.
The purpose of family child care provider is to provide a safe and nurturing environment for children to learn and grow while their parents or guardians are not available to care for them.
The specific information that must be reported on a family child care provider can vary, but it often includes details such as the provider's name, contact information, qualifications, capacity for children, and any relevant certifications or licenses.
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