Know how youll contact one another and reconnect if separated. Required information for HHS checklist, 110.8(4)A. This 2-sided, 8 1/2 x 11 handout provides child care providers with a method for communicating with families about the care of their infant. Health and Safety Forms. Links to resources that child care businesses might find helpful. Attorney, Terms of CCR&R provides training and support to child care centers in order to achieve and maintain regulatory status in good standing and improve the quality of care provided to children. Iowa Department of Human Services (DHS) Foster Parent Handbook, DHS Forms, etc. Regulation guidelines from the Department of Health and Human Services (HHS) and the Fire Marshal, which explains the minimum requirements for centers in Iowa. Required information from Department of Health and Human Services (HHS) checklist, 109.12(5)e. Safe Sleep procedures for providers and parents. A direct link to the Iowa Department of Health Smoke-Free Air Act information including a link to print signs. Ifyou believe that this page should betaken down, please follow our DMCA take down process, Ensure the security ofyour data and transactions, Project Clearance Report - Visit Mississippi - Visitmississippi, ALL STEPS ON THIS FORM MUST BE COMPLETED - Mde Maryland, SOLDIER SQUAD PERFORMANCE RESEARCH INSTITUTE (S2PRINT), Identity If you were directed here from the Human Services benefits portal because you do not have an email address, download theHHS Food and Financial Support Application(Solicitud de Ayuda Financiera) to apply. Fire and tornado drills are practiced monthly and documentation kept on file for the current year and previous year. 800-362-2178 - Please call if you suspect a child under the age of 18 is being abused or neglected or visit Iowa Department of Health and Human Services (HHS) child abuse website. Des Moines, IA 50305. Save the papers or print your PDF version. Required information from Department of Health and Human Services (HHS) checklist, 109.9 (2)d and f. Parent consent and release form addressing child pick up, trips, transportation, swimming, photos and other. Council Bluffs, IA 51503-4470 Fax: 515-564-4040 email: facilities@dhs.state.ia.us. The fact sheet includes color pictures of bed bugs andresources. CCR&R is committed to ensure that Iowa's vision is met. Supporting Breastfeeding is a 2-page, 8 1/2 x 11 fact sheet on ways child care providers can support breastfed infants and their parents. CCR&R provides training and support to child care businesses in order to achieve and maintain regulatory status in good standing and improve the quality of care provided to children. Required information from Department of Health and Human Services (HHS) checklist, 109.7(2). PROMISE JOBS staff administer Child Care Assistance for child care needed to participate in PROMISE JOBS activities. Required information for HHS checklist, 110.9(4)I and J. Iowa Child Care Resource & Referral provides resources, education and advocacy to support quality child care. Child Care Assistance To apply for Child Care Assistance, go to the Human Services Client Portal. Are You Ready to Start a Child Care Business? Iowa DHS Recruitment and Retention Bonus Program . The provider should give to the parent/guardian of the attending child for completion. Are you a center director or board member looking for suitable candidates to join your child care center? The provider should then keep a copy of this form in the child's personal file. #1 Internet-trusted security seal. Being identified to community resources, such as extension services, Community Action programs, Head Start and Child Care Nurse Consultants and Child Care Resource & Referral (CCR&R) agencies. Recruitment and Retention Bonus Application Recruitment and Retention Bonuses FAQ Box 4826 Des Moines, IA 50305 Fax to: 515-564-4034 Email: recordcheckevals@dhs.state.ia.us CASH ASSISTANCE Employer's Statement of Earnings 470-2844 Financial Support Application 470-0462 Report on Incapacity 470-0447 Request for FIP Beyond 60 Months 470-3826 Box 4826Des Moines, IA 50305Fax to: 515-564-4034Email:recordcheckevals@dhs.state.ia.us, Employer's Statement of Earnings 470-2844, Request for FIP Beyond 60 Months 470-3826, Requirements of Claiming Good Cause 470-0170, Review/Recertification Eligibility Document 470-2881, Ten-Day Report of Change for FIP and Medicaid 470-0499, Informe de Cambios de Diez Dias para FIP y Medicaid 470-0499(S), Solicitud de Ayuda Financiera 470-0462(S), Financial Support Application 470-0462(Multi-Program*), Child Care Assistance Application 470-3624(Child Care Assistance Only), Solicitud Para Child Care Assistance 470-3624(S)(Solamente Child Care Assistance), *Multi-program application can be used to apply for Food Assistance, Child Care Assistance, and Cash Assistance, Health Care Coverage and Help Paying Cost Application 470-5170, Solicitud de cobertura mdica y asistencia para abonar el costo 470-5170(S), Authorization to Obtain or Release Health Care Information 470-3951, Request to Amend Health Information 470-3950, Request for a List of Disclosures 470-3985, Request to Restrict Use or Disclosure of Health Information 470-3953, Request for Access to Health Information 470-3952, Request to Change How Health Information is Provided 470-3947, Autorizacion para Obtener o Proporcionar Informacion Sobre el Cuidado de la Salud 470-3951(S), HIPAA Privacy OfficerIA Dept of Human Svcs1305 E WalnutDes Moines, IA 50319, Consumer Directed Attendant Care Individual Provider Enrollment - 470-3638, HCBS Consumer-Directed Attendant Care Agreement 470-3372, Suspected Dependent Adult Abuse Report 470-2441, Central Abuse RegistryIA DHSP.O. This 10-page, 8 1/2 x 11 documenthas an easy-to-use format for writing an exposure control plan. Minimum required training for staff during first 3 months of employment: CCR&R Professional Development Opportunities - Online and face-to-face options, Child Care Ready - Series for new staff to meet 3-month training for requirements, Child Development Associate (CDA) Credential - Series for staff to improve competency standards, HHS Approved Professional Development Opportunities - Tools, trainings and resources, Iowa Early Learning Standards - Standards, benchmarks, examples and adult supports for Iowa Core Knowledge of Child Development. Asthma Care Brochure is a multi-color 2-page, 8 1/2 x 11 document to help child care businesses complete the Asthma Action Plan. This is a Department of Human Services (DHS) computer system, which may be accessed and used only by authorized users. The front has a weather chart, back has weather-related health information. A Child Care Center is: CCR&R Child Care Consultants are a resource to help improve the quality of care for all of Iowas children. If you do not know whether your provider is approved, ask your DHS CCA worker for assistance. 4 Compliances. services, For Small Child Care Assistance: Iowa offers subsidized child care for children in families with low incomes. If you were directed here from the Human Services benefits portal because you do not have an email address, download theApplicationfor Health Coverage and Help Paying Costs(Solicitudde cobertura mdica y sistencia para abonar el costo) to apply. Their work includes processing new applications, reviews, and changes reported by families receiving Child Care assistance. Is registered with Iowa Department of Health and Human Services (HHS), May or may not have a signed Child Care Assistance (CCA) Provider Agreement with Department of Health and Human Services (HHS), Is sometimes referred to as a registered home provider, Department of Health and Human Services (HHS) will complete annual inspections, Child and Adult Care Food Program (CACFP), Environment Rating Scale (ERS) Assessment, Registration & Regulatory Requirements - Department of Health and Human Services (HHS), Program for Infant/Toddler Care of Iowa (PITC), Registered with the Iowa Department of Health and Human Services (HHS), Not registered with Iowa Department of Health and Human Services (HHS), The only guideline for a Child Care Home (CCH) is Iowa Code Section 237A.3, To be available for referrals, a nonregistered program must complete a background check with CCR&R. Funding provided by the Iowa Department of Health and Human Services through the Child Care Development Fund, Iowa Department of Health and Human Services (HHS) child abuse website. Required information from Department of Health and Human Services (HHS) checklist, 109.10(1)c. Form parents complete if they refuse to immunize their children because of religion or doctor recommendation. Funding provided by the Iowa Department of Health and Human Services through the Child Care Development Fund, Child Care Home Accepting Child Care Assistance, Iowa Department of Health and Human Services (HHS) child abuse website. Access the most extensive library of templates available. This 2-page (8 1/2 x 11) form from the American Diabetes Association may be used forcare planning for children with diabetes. Consultation topics may include: Contact a CCR&R Community Development Specialist in Your Area. Click on County DHS Office Locations to find the location of the county DHS office nearest you. 2309 Euclid Avenue Des Moines, IA 50310-5703 You can also get an application form from any county Department of Human Services (DHS) office. Professional Development Record (Spanish) (Word) form to assist individuals in their professional development plan. Child Development Home B USLegal fulfills industry-leading security and compliance standards. Record Check Evaluation 470-2310Evaluacion de Cheque del Registro 470-2310(S)Send forms to: Record Check EvaluationIowa DHSP.O. This link will take you to the Iowa Child Restraint Law document. We use cookies to improve security, personalize the user experience, enhance our marketing activities (including cooperating with our marketing partners) and for other business use. This 2-page (8 1/2 x 11) fact sheet provides information on national standards for playground surfacing and preventing injuries. Child Care Consultants provide on-site consultation to licensed preschools, centers, nonregistered home providers and Child Development Home providers. Funding provided by the Iowa Department of Health and Human Services through the Child Care Development Fund A to Z Learning Center & Day Care-Donald. American with Disabilities Act (ADA) - FAQ for child care programs, Area Education Agency (AEA) - Special Education Services, Birth to 21, Child and Adult Care Food Program (CACFP) - Reimbursement Program for Meals & Snacks, Child Care Nurse Consultant (CCNC) - Experts in Child Health, Care & Safety, Child Care WAGE$ IOWA - Salary Supplement Program, First Children's Finance - Business Resource Center for Child Care Centers, Iowa DCI - Launchpad for Non-Criminal Justice Forms, Iowa Source Link - Helping Iowa Business Start and Grow, T.E.A.C.H. If you are seeking child care, call the Child Care COVID-19 Communications, Response and Referral Center: 1-800-446-1114. My Account, Forms in We use cookies to improve security, personalize the user experience, enhance our marketing activities (including cooperating with our marketing partners) and for other business use. Required information for HHS Checklist, 110.8(1)G and H. Information should be readily accessible for equipment checks of smoke detectors, carbon monoxide detectors, fire extinguisher and evacuation equipment. If you have employees with child support questions, they can get more information about our services, including payment information, by calling the child support automated information line at 888-229-9223 or go online to childsupport.ia.gov . Adoption 600.8(1)(2). Are you new to having a family or maybe you are new to Iowa? Forms and resources to help with budget planning for your Child Care Center including fiscal management, fundraising and reports. Iowa Department of Human Services DEPENDENT ADULT ABUSE A Guide for Mandatory Reporters Comm. Child care staff use to document an injury or accident. Box 4826Des Moines, IA 50305, Payment Application for Nonregistered Providers 470-2890, Child Care Assistance Provider Agreement 470-3871, Non-Law Enforcement Record Check Request Form A 595-1489, Non-Law Enforcement Record Check Request Form A (Spanish) 595-1489, Central Child Care Unit1305 E Walnut StDes Moines, IA 50319-0114, 2023 Iowa Department of Health and Human Services, Civil Commitment Unit for Sexual Offenders, Evaluacion de Cheque del Registro 470-2310(S), Child Care Assistance Application 470-3624, Solicitud Para Child Care Assistance 470-3624(S). When you received Medicaid benefits, which includes capitation fees paid to a managed care organization, even if the plan did not pay for any services, the State of Iowa has the right to ask for money back from your estate after your death. Your data is well-protected, as we keep to the newest security requirements. Child Care Center Resources 9. **Under Construction - please stop back, this section undergoing frequent updates, Orientation Guidebook to Child Care Licensing in Iowa, Child Care Consultant Area Map - DHS Licensing Consultant Map, Emergency Preparedness - Template and Tools, Iowa Quality for Kids (IQ4K) - Quality Rating and Improvement System, Recruitment & Retention - Recruitment for Early Childhood Professionals. Iowa Administrative Code Chapter 109 5. Required information for HHS checklist, 110.8(3)C. Form to be completed by the parent and provider when an enrolled child is given any medicine, topical cream, sunscreen, diaper ointment, breathing treatment, etc. Planning, Wills Center Director Requirements 4. Required information for HHS checklist, 109.10(1). Did you know there is a program called Iowa Child Care Reso HHS to increase the CCA rate tables for all child care providers. If you live in Iowa, call the state office at 1-800-532-1579. Required information for HHS checklist, 110.9(4)D. The provider should give this form to the parent/guardian of the attending child, to have the form completed by a physician. Only use this application if youdo nothave health coverage and wish to be tested for COVID-19. Childcare Compliance and Complaint Reports: Search a listing of all licensed child care centers and homes to view their annual compliance evaluations and any complaint reports that have been filed. The provider should give to the parent/guardian of the attending child for completion. Get access to thousands of forms. Assistance may also be available for a limited period of time to the children of a parent looking for employment. 1-page, 8 1/2 x 11 handout explains who should take this course and the eligibility requirements. This 2-page, 8 x 11 form meets Iowa's child care regulations that require an annual parent statement about their school-age child's health. Forms, Real Estate Choose the document template you need from our collection of legal forms. The form was developed by the Iowa Department of Education, Bureau of Nutrition and Health Services (11/2017). Those serving more than 5 children are required to register with the Iowa Department of Health and Human Services (HHS). If you have questions it is best to contact the board administrator for direction. Please contact your Child Care Consultant with any questions you may have. You can apply for the FPP at an FPP family planning clinic. Healthy Child Care Iowa (HCCI) offers the products below to assist you in offering quality child care to Iowa's children. Child Care Injury/Incident Report is a 2-page, 8 1/2 x 11 form to be completed any time an injury that requires first aid or medical care which occurs in a child care home, child development home, or licensed child care facility. Iowa Child Care Resource & Referral provides resources, education and advocacy to support quality child care. Guide, Incorporation This updated (April 2022) 1-page (8 1/2 x 11) first aid checklist may be used by child care providers for assessing and monitoring first aid kits. Chapter 237A also requires centers to comply with state health and fire safety laws. If you suspect child abuse, contact the local law enforcement and the Iowa Child Abuse Hotline at 1-800-362-2178. (515) 281-5255 Des Moines, Iowa 50319 (515) 281-0246 . Child Health Exam Forms Infant, Toddler, Preschool Age Child Health Form This 2-page (8 1/2 x 11) form meets Iowa's child care regulations that require an annual physical exam for infant, toddler and preschool age (including kindergarten entry) children. Download the English version of this form 844-786-1296 please call the Iowa Child Care Complaint Hotline if you have concerns regarding a child care provider. The Infant Safe Sleep Policy follows the American Academy of Pediatrics' infant safe sleep standards to prevent sudden infant death syndrome (SIDS) and sleep-related deaths. Service, Contact Required information for HHS checklist, 110.8(1)A. Enter all necessary information in the required fillable areas. Spanish, Localized Fire Marshal Requirements - Iowa State Fire Marshal's Office, Comm 204 - HHS Licensing Standards & Procedures, Comm 204, Section 109.6(1-5) - Requirements for Center Director and On-Site Supervisor, Comm 204 - Center Director Qualifications Point Chart, Comm 204 - On-Site Supervisor Qualifications Point Chart, Comm 204 - School-age Director Qualifications Point Chart, Comm 204 - School-age On-Site Supervisor Qualifications Point Chart, Chapter 170 - Requirements for Child Care Assistance (CCA), Child Care Assistance Forms and Information, Department of Health and Human Services (HHS) Child Care Provider Portal, Emergency Preparedness - Resources to help write plans and procedures, Fingerprints and SING - Record check guide. This self-assessment will be used by the provider and Child Care Consultant to assure homes are a safe, nurturing place for children that promote developmentally appropriate practices. The intuitive drag&drop graphical user interface allows you to include or relocate fields. Guide, Incorporation If you are not able to find what you are look for please contact your Licensing specialist or send an email to Childcare.OCCS@okdhs.org. Did you know there is a program called Iowa Child Care Reso HHS to increase the CCA rate tables for all child care providers. Licensed Center. The provider should then keep a copy of this form in the child's personal file. Pediatric Migraine Action Plan is a 3-page, 8 1/2 x 11 form child care businesses may use when planning the care of a child with migraines. e. Has achieved a total of 100 points obtained th rough a combination of education, experience, and . Click on County DHS Office Locations to find the location of the county DHS office nearest you. as they maintain information to provide parent . This 1-page, 8 1/2 x 11 color poster provides information on gloving. 07012020CCAPMemo (pdf)Note: COVID-19 July 1st Changes. ARE YOU ADDING, CHANGING OR CANCELING THIS AGREEMENT? Required information for HHS checklist, 110.8(5)A through D. Safe Sleep procedures for providers and parents. Thisis a 2-sided(8 1/2 x 11) color brochure. Iowa Department of Human Services (DHS) Application Packet for home child care: Whether youre a Child Care Center, preschool, Child Development Home, school-age program or someone who is just thinking about starting your own child care business, we have the tools you need to become successful in the IQ4K program. ) a offers subsidized child Care Resource & Referral provides resources, education and to! To include or relocate fields participate in promise JOBS activities 51503-4470 Fax: email. Reconnect if separated a copy of this form in the child 's personal file you... Color pictures of bed bugs andresources th rough a combination of education, experience, and Care Reso HHS increase! 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