Provider Updates Provider Name Contact Person Business Name Address Mailing Address (if different from above) Phone Fax E-Mail Address License Number License Expiration Date Type of Care Center Family (FCC) Group Preschool Program School Age Program (CCC) Drop In (CCC) PPI - Special Needs (CCC) Exempt School Age Licensed Capacity Desired Capacity Number of Vacancies As of (Date) Accepts Ages Beginning at Accepts Ages Ending at School District Elementary School Transportation Provided (Close to bus stop) Yes No Walking Distance to School Yes No Near Public Transportation (Parents) Yes No Languages Spoken other than English Days of Operation Sunday Monday Tuesday Wednesday Thursday Friday Saturday Start Time End Time Accepts Children Full Time Part Time Both Duration Full Year School Year Summer Only Other Drop In Before School Rotating (weeks) Open Holidays Temp./Emergency After School 24 Hour Costs:Infant:Full Time - Weekly Costs:Infant:Part Time - Weekly Costs:Infant:Full Time - Day Costs:Infant:Part Time Day Costs:Infant:Hourly Costs:Infant:Other Costs:Toddler:Full Time - Weekly Costs:Toddler:Part Time - Weekly Costs:Toddler:Full Time - Day Costs:Toddler:Part Time Day Costs:Toddler:Hourly Costs:Toddler:Other Costs:Preschool:Full Time - Weekly Costs:Preschool:Part Time - Weekly Costs:Preschool:Full Time - Day Costs:Preschool:Part Time Day Costs:Preschool:Hourly Costs:Preschool:Other Costs:Kindergarten:Full Time - Weekly Costs:Kindergarten:Part Time - Weekly Costs:Kindergarten:Full Time - Day Costs:Kindergarten:Part Time Day Costs:Kindergarten:Hourly Costs:Kindergarten:Other Costs:School Age:Full Time - Weekly Costs:School Age:Part Time - Weekly Costs:School Age:Full Time - Day Costs:School Age:Part Time Day Costs:School Age:Hourly Costs:School Age:Other Costs:Latch Key:Full Time - Weekly Costs:Latch Key:Part Time - Weekly Costs:Latch Key:Full Time - Day Costs:Latch Key:Part Time Day Costs:Latch Key:Hourly Costs:Latch Key:Other Costs:Co-Op (2 days) Costs:Co-Op (3 days) Additional Activity Fee Additional Registration Fee Age Group:CCC 0-12 Months Desired Cap Age Group:CCC 0-12 Months Licensed Cap Age Group:CCC 0-12 Months Vacancies Age Group:FCC 0-18 Months Desired Cap Age Group:FCC 0-18 Months Licensed Cap Age Group:FCC 0-18 Months Vacancies Age Group:CCC 1-2.5 Years Desired Cap Age Group:CCC 1-2.5 Years Licensed Cap Age Group:CCC 1-2.5 Years Vacancies Age Group:FCC 18M-2.5Yrs Desired Cap Age Group:FCC 18M-2.5Yrs Licensed Cap Age Group:FCC 18M-2.5Yrs Vacancies Age Group:ALL 2.5-5 Years Desired Cap Age Group:ALL 2.5-5 Years Licensed Cap Age Group:ALL 2.5-5 Years Vacancies Age Group:Kindergarten Desired Cap Age Group:Kindergarten Licensed Cap Age Group:Kindergarten Vacancies Age Group:First Grade+ Desired Cap Age Group:First Grade+ Licensed Cap Age Group:First Grade+ Vacancies Environment Smoke Free Air Conditioning Fenced Yard No Pets Pool/Lake Meals Child Care Food Program Breakfast AM Snack Lunch PM Snack Special Diet Dinner None (BYO) Financial Assistance Scholarship FIA/DHS Direct Payments Free Preschool (HS/SR) Sibling Discount Parent Co-Op Special Needs Services Provided 4C Training Basic Advanced Administrative Infant A, B, or C Mini Special Needs Other Training Medical Training CPR/First Aid Experience (Family & Group) FCC: 2-5 years FCC: >5 years FCC: Exp as parent FCC: Workshops/Conferences FCC: Special Needs Exp. Director Education HS Diploma/GED VO Tech Some College ECE/CDA/ZA Associates Bachelors Masters Head Teacher Education HT = 18yrs/HS Diploma/GED HT = AA or CDA HT = BA/MA HT = BA + ECE Accreditation NAEYC NAFCC NSACA CDA SAC Affiliation For Profit Non Profit Multi Site School Government Faith-Based Employer-Sponsored Vacancy Update Info Aware of T.E.A.C.H. Have UAW Ford/Visteon Children Have FIA/DHS Children Special Programs Montessori Religious Academic Child Development Parent Involvement Setting House Mobile House Non residential Apartment Duplex Faith Based Townhouse/Condo Work Place Based Optional Before/After Kindergarten Summer School Age All Day Kindergarten Preschool Program Elem. Grades on Site

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