ATTACHMENT 1.41
NOTIFICATION OF VOLUNTARY PREKINDERGARTEN (VPK) CHILD’S EXCUSED ABSENCES
3 – Unexcused absences allowed each month: If a child’s absence is unexcused, the absence is payable, not to exceed three unexcused absences per calendar month.
More than 3 absences in a month require the following: The PROVIDER agrees that it shall follow the notification requirements adopted by the COALITION for submitting written documentation given to the PROVIDER describing a child’s excused absences.
Please use ATTACHMENT 1.47 – REQUEST FOR APPROVAL OF PAYMENT FOR VPK ABSENCES. You must submit this attachment for every child’s excused absences each month with the monthly attendance. This will allow you to receive proper payment and adjustments to your payment may not be needed as frequently. The parent/guardian of the child must sign this form.
Amount of Absences allowed: The parent/guardian may document seven or fewer excused absences per calendar month. Beyond seven excused absences, a person other than the child’s parent must document the excused absence. The person must be unrelated to either the child or the child’s parent/guardian, and the documentation must show that the person has personal knowledge of the reason for the absence (a letter from a physician, for example).
Please attach all absence notes to the Attachment 1.47 and included them with your Monthly Enrollment Attendance Verification form.
3111 S. Dixie Highway, Suite 222 ● West Palm Beach, FL 33405
11-8-07
ATTACHMENT 1.47
Request for Approval of Payment – VPK Absences
DIRECTIONS: Complete all information requested below. This request should be attached to the Attendance Roster and submitted for consideration. Please Print.
Provider’s Name _________________________________________________________________ (Full Facility Name)
Child Name ______________________________________________________ Eligibility: VPK (Last) (First) (MI) Parent Name _______________________________________________ Classroom: __________ (Last) (First) (MI) ABSENCES: List dates of ALL absences for current month. All requests of absences over three (3) days must be submitted for consideration of approval for payment and accompanied with documentation. Dates and Reason for Absences: ___________________________________________________________________________________ ___________________________________________________________________________________ ___________________________________________________________________________________ ___________________________________________________________________________________
____________________________________________________________________________ ___________________________
SIGNATURE OF PARENT/GUARDIAN
_______
DATE
_____________________
SIGNATURE OF PROVIDER
________
DATE
FOR OFFICE USE ONLY Recommended approval for (number of days) Approval not recommended Return/Incomplete _________ Illness __________Vacation _________ Other
Information or document to support this request must be attached. Request approved, Enter “E” on attendance Report. Request denied, Enter “N” on.
__________________________________________________ SIGNATURE OF CIS MANAGER
_________________ DATE
3111 S. Dixie Highway, Suite 222 ● West Palm Beach, FL 33405
11-8-07