Child Care Aware of NWA
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Child Care Aware of NWA
Child Care Aware of the River Valley
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Provider Update Form
Please complete this form and check all applicable boxes below.
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Program/Business Name
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License Number
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Primary Contact/Director Full Name
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First
Last
Program/Business Address
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Line 1
Line 2
City
State
Zip Code
Country
Mailing Address(if different from Business Address)
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Line 1
Line 2
City
State
Zip Code
Country
Phone Number
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Fax Number
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Email
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Website URL or Facebook (if you have one)
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Type of Care
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Licensed FDC Home
Registered FDC Home
Licensed Center
School Age Program
Faith-Based Program
Mother's Day Out
Part-Time Preschool
For Profit
Non-Profit
Operation Schedule
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Full Year
School Year
Summer Only
Drop-In
Days Open
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Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Part-Time Option 1
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Option 1
Option 2
Option 3
Part Time Option 2
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Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Hours of Operation
Monday
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Tuesday
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Wednesday
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Thursday
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Friday
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Saturday
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Sunday
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Ages Served:
Licensed Age From
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Licensed Age to
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Total Capacity
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Desired Capacity
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Full Time Vacancies
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Part Time Vacancies
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Full-Time Rates
Age
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0-18 Months
$ Rate
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Per
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Hour
Day
Week
Month
Age
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18-36 Months
$ Rate
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Per
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Hour
Day
Week
Month
Age
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2 1/2-5 Years
$ Rate
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Per
*
Hour
Week
Day
Month
Age
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School Age-Summer
$ Rate
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Per
*
Hour
Day
Week
Month
Part-Time Rates
Age
*
0-18 Months
$ Rate
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Per
*
Hour
Day
Week
Month
Age
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18-36 Months
$ Rate
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Per
*
Hour
Day
Week
Month
Age
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2 1/2 - 5 Years
$ Rate
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Per
*
Hour
Day
Week
Month
Age
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School Age-Before School
$ Rate
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Per
*
Hour
Day
Week
Month
Age
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School Age - After School
$ Rate
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Per
*
Hour
Day
Week
Month
Age
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School Age - Summer
$ Rate
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Per
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Hour
Day
Week
Month
Number of Staff
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Enviornment
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Enrichment Activities
Computers/Technology
Pets
Field Trips
Health/Safety
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Heart Association/Red Cross First Aid/CPR Certified
Medical Related Certification
Developmental Delay & Disability Training
Nutrition & Physical Activities Policy
Other
Meals Served
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Breakfast
Morning Snack
Lunch
Afternoon Snack
Dinner
Late Snack
Special Meal Request
USDA Food Program
CCFP Participant
Accreditation
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Better Beginnings
Getting Ready
Level 1
Level 2
Level 3
NAEYC
NAFCC
CARF
NAEYC
ASAP
Other
Transportation
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Do Not Transport
Transport Provided
On School Bus Route
To and From Home
Near Public Transportation
Walking Distance to School
Financial Assistance
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ABC Program
Head Start
Multi-Child Discount
TANF
TEA
Voucher Program
Career Pathways
Military Child
Scholarships
Special Needs
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Dispensing Medicine
Emotional/Behavioral
Feeding Tubes
Health/Mental Disability
Monitors
Occupational Therapy
Physical Disability
Special Diets
Speech
Wheelchair Accessible
Additional Professional Development
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Meets Min Licensing Training Standards
Exceeds Min Licensing Training Standards
Director/Owner Education
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(CDA) Child Development Associate
Associates Degree or 60 college hours
21-30 college hours for ECE/CD
9-21 college hours for Management
Bachelor's Degree
Master's or Other Advanced Degree
Director/Owner Experience
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0-5 Years
6-10 Years
11-15 Years
16-20 Years
More than 20 Years
Do you charge parents if their child does not attend (i.e. family vacation time, child sick, etc.)?
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