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Data Reporting for Indian Tribes; ACF-700 Form

Index: ACYF-PI-CC-01-09 | ACF-700 Form | Tribal Annual Report: Guide for CCDF Tribal Lead Agencies (updated 11/2001)

Related Items: ACF Regional Administrators | ACF-700 Help | CCDF Annual Report for Tribal Lead Agencies (11/2000)
 

ACF-700 Form (also available in Excel)

CHILD CARE AND DEVELOPMENT FUND ANNUAL REPORT
ON SERVICES PROVIDED FROM OCTOBER 1, 2000 THROUGH SEPTEMBER 30, 2001
OMB Approval Number: 0980-0241
Expires:11/30/04

COMPLETE NAME OF TRIBAL LEAD AGENCY:

ADDRESS:

CONTACT PERSON/PHONE/E-MAIL:

 (A)
TOTAL 		CATEGORY/TYPE OF CHILD CARE
CARE PROVIDED BY A CCDF PROVIDER -- NO LICENSE CATEGORY AVAILABLE IN A CARE PROVIDED BY A CCDF PROVIDER --LICENSED OR REGULATED IN A
CHILD'S HOME BY A FAMILY HOME BY A GROUP HOME BY A (H)
Center		 (I)
Child's Home		 (J)
Family Home		 (K)
Group Home		 (L)
Center
(B)
Relative 		(C)
Non-Relative 		(D)
Relative 		(E)
Non-Relative 		(F)
Relative 		(G)
Non-Relative
1. Number of families receiving child care services                         
2 a. Average number of children served per month  
2 b. Total number of children receiving child care services                        
3. Age breakdown of children receiving child care services:
a. 0 up to 1 year
b. 1 year up to 2 years
c. 2 years up to 3 years
d. 3 years up to 4 years
e. 4 years up to 5 years
f. 5 years up to 6 years
g. 6 years up to 13 years
h. 0 up to 13 years(sum of rows 3a thru 3g)
i. 13 - and older

a.
b.
c.
d.
e.
f.
g.
h.
i.

a.
b.
c.
d.
e.
f.
g.
h.
i. 		a.
b.
c.
d.
e.
f.
g.
h.
i. 		a.
b.
c.
d.
e.
f.
g.
h.
i. 		a.
b.
c.
d.
e.
f.
g.
h.
i. 		a.
b.
c.
d.
e.
f.
g.
h.
i. 		a.
b.
c.
d.
e.
f.
g.
h.
i. 		a.
b.
c.
d.
e.
f.
g.
h.
i. 		a.
b.
c.
d.
e.
f.
g.
h.
i. 		a.
b.
c.
d.
e.
f.
g.
h.
i. 		a.
b.
c.
d.
e.
f.
g.
h.
i. 		a.
b.
c.
d.
e.
f.
g.
h.
i.
4. Number of children receiving child care services because:
a. Parent is (or parents are) working
b. Parent is (or parents are) in training or education program
c. Child is receiving or in need of protective services		 a.
b.
c.		            
5. Average number of hours of child care service provided
per week per child per month		                        
6. Average monthly amount paid for child care service per child
a. Average monthly CCDF subsidy
b. Average monthly parent copayment		 a.
b. 		                     

7. Number of children receiving child care services from families with income:
a. at or below the poverty threhold for families of the same size
b. above the poverty threshold but at or below 150 percent of the poverty threshold for families of the same size
c. above 150 percent of the poverty threshold but at or below 200 percent of the poverty threshold for families of the same size
d. above 200 percent of the poverty threshold for families of the same size

a.
b.
c.
d.

           
Comments:


Index: ACYF-PI-CC-01-09 | ACF-700 Form | Tribal Annual Report: Guide for CCDF Tribal Lead Agencies (updated 11/2001)

Related Items: ACF Regional Administrators | ACF-700 Help | CCDF Annual Report for Tribal Lead Agencies (11/2000)