CCDF Submission of the Case-Level Report (ACF-801) |
| Index: ACYF-PI-CC-98-01 | ACF-801 Form | ACF-801 Instructions | Sampling Specifications | (Collection also available in Word and PDF) |
| Related Items: ACF Regional Administrators | 2001 Case-level Data Report (ACF-801) | FIPS Code Listing | Standards on Race and Ethnicity Data |
ACF-801 Case-Level Reporting Instructions and Definitions (also in Word) |
ACF-801 CHILD CARE QUARTERLY CASE-LEVEL
REPORTING FORM
Instructions and Definitions
NOTE: These instructions are for the manual preparation of the ACF-801 Form. Instructions will also be made available for the electronic submission of the ACF-801 at a later time.
All elements are required unless specified as optional.
HEAD OF FAMILY: The following group of elements (items 1-9) refers to the head of the family receiving child care assistance that is being reported on this form.
1. Reporting Period: Enter the numbers that identify the month and year being reported.
2. Unique State Identifier (Optional): Enter the unique identifying number, up to fifteen characters, assigned by the State to the family receiving child care assistance. States may use alphanumeric characters. If identifier is less than fifteen digits, use leading zeros. For example, 19056 should be coded as 000000000019056.
3. Social Security Number: Enter the Social Security Number of the head of the family. THIS ITEM IS NOT OPTIONAL.
4. Federal Information Processing Standards (FIPS) Code: Enter the FIPS Code geographic identifier issued by the National Bureau of Standards to designate where the head of the family receiving assistance is residing. If the address of the head of the family is unknown, leave the county FIPS code blank. A list of all FIPS codes can be found at the Child Care Bureau's Technical Assistance Web site or by contacting your State's Child Care Automation Technical Assistance Liaison (1-888-821-6997).
a) State code, two digits, and
b) County code, three digits
5. Single Parent? (Yes/No): Enter the one digit code indicating if the head of the family receiving assistance is single or not.
0 -- No
1 -- Yes
9 -- Not applicable; child is reported as head of household. (If "9"
is selected, enter the Child's Social Security Number in Item 3).
6. Reason for Receiving Subsidized Child Care: Enter the one digit code indicating the reason for receiving subsidized child care. If more than one category applies, chose the primary reason. However, if 5 -- "Other" is one of the possibilities, it should not be chosen.
1 -- Employment, including on-the-job training
2 -- Training/Education
3 -- Both Employment and Training/Education
4 -- Protective Services
5 -- Other
7. Total Monthly Child Care Copayment By The Family Receiving Assistance: Enter the total monthly dollar amount that the family receiving assistance must pay for child care services for the month being reported, using leading zeros as necessary.
8. Month/Year Child Care Assistance to the Family Started: Enter the numbers for the month and year child care assistance started for the family receiving assistance. If there was a short interruption of up to three months in child care assistance (for reasons such as a vacation or illness) enter the original month/year the assistance started, rather than when the assistance resumed.
9. Total Monthly Income for Determining Eligibility: Enter the total monthly dollar amount upon which eligibility is determined, rounded to the nearest dollar amount using leading zeros as necessary.
FAMILY INCOME BY SOURCE: Enter the code for yes or no for all sources of income that apply to the family receiving assistance for the month being reported. If income is not used to determine eligibility for protective services cases, elements 10-15 may be left blank.
10. Employment income, including self-employment.
11. Cash or other monetary assistance under Title IV of the Social Security Act (Temporary Assistance to Needy Families).
12. State Program for Which State Spending is Counted Towards Temporary Assistance to Needy Families MOE.
13. Housing voucher or cash assistance.
14. Assistance under the Food Stamps Act of 1977.
15. Other Federal Cash Income Programs (such as SSI).
0 -- No
1 -- Yes
DEPENDENT CHILDREN RECEIVING CHILD CARE ASSISTANCE: This group of elements refers to dependent children in the family receiving child care assistance, and specifies demographic and child care service elements of children receiving care. Child care data in this section must be coded for dependent children receiving care.
16. Child's Social Security Number (Optional): Enter the Social Security Number of the child receiving assistance.
17. Hispanic or Latino: Enter the one digit code for the ethnicity of each child. Ethnicity must be determined for every child.
0--No
1--Yes
ITEMS 18 - 22 apply to each child receiving care. Enter the code for yes or no for each race listed below. Select yes for as many races as reported by the family. Each child must have at least one race coded yes.
American Indian or Alaskan Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White
0 -- No
1 -- Yes
1 -- Male
2 -- Female
24. Month/Year of Birth: Enter the numbers for the month and year of birth of the child receiving care.
ITEMS 25-27 apply to the child care provided to each child. Enter the child care data for the greatest number of hours of care provided in the line for Provider 1 for each child, and the next highest number of child care hours on the Provider 2 line. If more than two providers are used by a child, attach the responses to these items for each additional provider.
25. Type Of Child Care:
Definitions: Provider types are divided into two broad categories of licensed/regulated and legally operating (no license category available in state or locality). Under each of these categories are four types of providers (use your State's definition of these terms): in-home, family home, group home, and centers. A relative provider is defined as being at least 18 years of age and who is a grandparent, great-grandparent, aunt or uncle, or sibling living outside the childs home.
Instructions: Enter the type of care, two-digit code, for each child. The following codes specify who cared for the child and where such care took place during the sample month.
Codes:
01 -- Licensed/regulated in-home child care
02 -- Licensed/regulated family child care
03 -- Licensed/regulated group home child care
04 -- Licensed/regulated center-based care
05 -- Legally operating (no license category available in state
or locality) in-home care provided by a non-relative
06 -- Legally operating (no license category available in state
or locality) in-home care provided by a relative
07 -- Legally operating (no license category available in state
or locality) family child care provided by a non-relative
08 -- Legally operating (no license category available in state
or locality) family child care provided by a relative
09 -- Legally operating (no license category available in state
or locality) group home child care provided by a non-relative
10 -- Legally operating (no license category available in state
or locality) group home child care provided by a relative
11 -- Legally operating (no license category available in state
or locality) center-based care
26. Total Monthly Amount Paid to the Provider: For each child receiving care, enter the total monthly dollar amount (round to the nearest dollar and use leading zeros as necessary) expected to be paid to the provider for the care of the child. The total monthly amount should include Federal, State, and locally funded amounts.
27. Total Hours of Care Provided in the Month: Enter the number for the total number of hours provided for the reporting period (round to the nearest whole number and use leading zeros as necessary).
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| Index: ACYF-PI-CC-98-01 | ACF-801 Form | ACF-801 Instructions | Sampling Specifications | (Collection also available in Word and PDF) |
| Related Items: ACF Regional Administrators | 2001 Case-level Data Report (ACF-801) | FIPS Code Listing | Standards on Race and Ethnicity Data |