Child Action Inc Attendance Form Instructions for Providers and by wantyou

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									     Child Action, Inc. Attendance Form Instructions for Providers and Parents
The following are instructions for completing Attendance Forms. Failure to comply with any of these guidelines
could result in non-payment or partial payment for child care. Please read carefully.

Billing:
1. The provider must fill in the rate used and check the type of rate it is. For example, if the provider charges
   $20 a day and care was used 21 days of the month, he/she would mark the “Daily Rate” box on the front
   side of the Attendance Form and complete as follows:
            Daily Rate: $    20.00        / day [X]    21         # of days

2. The provider must record the rate and number of days/hours for additional charges such as in-service and
   minimum days in the “Other Charges” section.

3. The provider must indicate the dollar amount for registration fees charged in the “Other Charges” section.

4. The front of the Attendance Form must be signed and dated by both provider and parent. Providers
   should make sure to sign at the end of the month so they can accurately verify the total hours of care used.
   Child Action, Inc. will not pay for days/hours that occur after the Attendance Form has been turned in or
   past the date of the signatures. Providers and parents should sign just as they would a check, and must
   sign for themselves only.

5. The back of the Attendance Form must be signed by the parent (or authorized pick-up person) twice
   each day that care is used. The State requires that a child be signed both in and out of care for each day
   care is provided. If a child uses after-school care only, the provider can sign the child in, but the person
   authorized to pick up the child must sign the child out. If a child uses before-school care only, the person
   authorized to drop off the child must sign the child in, but the provider can sign the child out. DAYS
   REQUIRING TWO SIGNATURES WILL NOT BE PAID IF EITHER SIGNATURE IS MISSING.


Attendance Form Codes:
The following is a list of Attendance Form codes and an explanation of how parents should use them.

C – Provider Closed
The “C” code is to be used when a provider is closed and unavailable to provide care for all or part of a
scheduled day of care.

S – Child/Parent Sick or at Doctor’s Appointment (medical)
The “S” code is to be used when:
   • any child is absent from care or uses fewer hours than scheduled due to a medically-related reason.
   • a school-age child is ill on a school day and is in care for more hours because of the illness.

A – Child Absence (non-medical)
The “A” code is to be used when a child is absent from care or uses fewer hours than scheduled due to a non-
medical reason. For example, use this code if you or your child are on vacation and your child does not use
care or uses fewer hours than scheduled.

NS – In-Service Day or School Holiday
The “NS” code is to be used for school-aged children only. It is used on days when school is closed due to a
school holiday or teacher in-service training. It explains why a school-aged child used more hours than s/he
would normally use on a school day (but within the approved hours on the CCS.)

M – Minimum School Day
The “M” code is to be used for school-aged children only. It is used to designate a minimum school day. It
explains why a school-aged child used more hours on a school day (but within the approved hours on the
CCS.) It can also be used to explain why a kindergartner’s school hours and child care hours change on a
minimum day.
                                                                                            086AFrules.doc (rev. 11-04)

								
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