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DPHHS-QAD/CCL-20A Revision 8-07 OFFICE USE CAPS DEPARTMENT OF PUBLIC HEALTH AND HUMAN SERVICES STATE OF MONTANA - RELEASE OF INFORMATION For Registered and Licensed Child Care Providers Criminal / Protective Service / Motor Vehicle Background Checks PERSONAL INFORMATION Section A Current Information Phone Legal Name First Middle Maiden Last Aliases/Other Names Used Residential Address Street City State Zip Mailing Address Sex Male Female Date of Birth Social Security Section B Past...
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How to fill out dphhs-qadccl-20a - dphhs mt
How to fill out DPHHS-QAD/CCL-20A
01
Begin by downloading the DPHHS-QAD/CCL-20A form from the official website.
02
Fill in the date at the top of the form.
03
Provide your personal information, including your name, address, and contact details.
04
Specify the type of service or assistance you are applying for in the designated section.
05
Include any required documentation or evidence to support your application.
06
Carefully review the form for any errors or omissions.
07
Sign and date the form at the bottom.
08
Submit the completed form to the appropriate department as instructed.
Who needs DPHHS-QAD/CCL-20A?
01
Individuals applying for certain services or assistance from the Department of Public Health and Human Services (DPHHS).
02
Organizations seeking licensing or certification in child care and related fields.
03
Care providers who need to document compliance with regulatory requirements.
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What is DPHHS-QAD/CCL-20A?
DPHHS-QAD/CCL-20A is a form used by the Montana Department of Public Health and Human Services for reporting compliance and background information regarding child care licensing.
Who is required to file DPHHS-QAD/CCL-20A?
Child care providers and facilities that are seeking or maintaining licensure in Montana are required to file the DPHHS-QAD/CCL-20A.
How to fill out DPHHS-QAD/CCL-20A?
To fill out the DPHHS-QAD/CCL-20A, you need to provide accurate and complete information about your child care facility, staff, and compliance with health and safety regulations as outlined in the form instructions.
What is the purpose of DPHHS-QAD/CCL-20A?
The purpose of DPHHS-QAD/CCL-20A is to ensure that child care facilities comply with state regulations and to collect necessary information for the licensing process.
What information must be reported on DPHHS-QAD/CCL-20A?
Information that must be reported includes the facility's address, ownership details, staff qualifications, compliance history, and any other relevant details regarding operations and safety measures.
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