Child Care Update Form

Type of Child Care Program:
Please choose one

Licensed Child Care Center‎ Licensed Child Care Center (SACC only)‎ Licensed Family Child Care (level 1)‎ Licensed Family Child Care (level 2)‎ Licensed Large Family Child Care‎ Exempt Child Care Center‎ Exempt School Age Program‎ Exempt Preschool‎ Exempt Camp‎

Other Type of Program included:
Please check all that apply

Camp‎ Preschool‎ School Age Program‎

Name of Child Care Program:

Name of Contact Person:

Email:

Program Address:

Mailing Street Address:
(if different from program address)

Phone:

Alt. Phone:

Fax:

Website:

Twitter:

Facebook:

Instagram:

YouTube:

License Number:

Expiration Date:

Is Your Program Exempt?

Yes‎ No‎

Exemption Number:

Regulated By:

Dept. of Education‎ Div. of Public Health‎ Other‎

Program's Total Capacity:

Youngest age program accepts: (yrs/mo)

Oldest age program accepts:(yrs/mo)

Schools Served: (Public and Private)

If your staff speak a language other than English please list:

Do any of your staff know sign language?

Yes‎ No‎

Do any of your staff know Braille?

Yes‎ No‎

Transportation:
Please check all that apply

Transportation Provided‎ Walking Distance to School‎ Near Public Transportation‎ On School Transportation Route‎

Which programs/schedules do you offer?
Please check all that apply

Preschool 2 mornings/week‎ Preschool 3 mornings/week‎ Preschool 5 mornings/week‎ Center Based Kindergarten Program‎

Time Open:
(Ex. 6:00AM. If 24 hour, use 12:00AM)

Time Close:
(Ex. 6:30PM. If 24 hour, use 11:59PM)

Time Comments:
(Ex. Close at 5:00PM on Sat. Open at 8:00AM on Sun.)

Please include information on the rates for each age group as you typically charge families. They can be listed hourly, daily, weekly, monthly, yearly and part-time or full-time.

Rates 0-12 months:

Rates 12-23 months:

Rates 2 year olds:

Rates 3 year olds:

Rates 4-5 year olds (not enrolled in Kindergarten):

Rates Kindergarten:

Rates School Age:

Is your program non-profit?

Yes No

Curriculum Used:

Child Assessment Used:

Quality Rating- Delaware Stars:
please choose one

What is your program Philosophy?
Please check all that apply

Financial Assistance Offered:
Please check all that apply

Safety Measures:
Please check all that apply

Criminal Background Checks‎ CPR/First Aid Certified‎

Other Special Needs:

What type of Accreditation does your program have?
Please check all that apply

What type of Affiliations does your program have?
Please check all that apply

Please list any other pets:

What Environmental Features does your program have?
Please check all that apply

What type of discounts does your program offer?
Please check all that apply

Sibling Discount‎ Employee Discount‎ Sliding Scale Discount‎ Military Discount‎

Please give current status on openings you have. We keep internal notes and recognize that these constantly change.

Please include a summary of your program that you would like families to see in your printed profile. This custom information is truly valued by our clients, and may influence their decision as to which referrals to contact first.

CAMP ONLY QUESTIONS

Do you offer the following camp activities?
Please check all that apply

Counselor in Training‎ Instructional Swimming‎ Recreational Swimming‎

Please list any Specialty Camps you offer that are not listed above.

Choose the sign-up schedules that are available to your campers.
Please check all that apply

What are your regular camp hours?

What are your extended hours?

Please list your rates for each option as families are charged. Please indicate if they are weekly, for two weeks, monthly or for the entire summer.

Rates for Regular Camp Hours:

Rates for Before Camp Hours:

Rates for After Camp Hours:

Date Registration Begins:

Date Camp Begins:

Date Camp Ends: