Past Your Bedtime Child Care

2009 N.63rd St.

Philadelphia, PA. 19151

(215) 877-7928

(215) 877-3885 Fax

Application for Child Care Services

Name of Child ______Birth date ______

Address______City______State ______

Zip Code______

Mothers Name or Legal Guardian ______

Mothers Address ______

Telephone Number ______

Father’s Name or Legal Guardian ______

Fathers Address ______

Telephone Number ______

If Parents are not married do both have legal custody? ______

If no, custody papers must be on file, or child will be released to both parents.

Mothers Occupation ______Business Number ______

Fathers Occupation ______Business Number ______

What are your child’s interest or hobbies e.g. Dancing, singing, ball, crafts, etc.

How would you describe your child e.g. (Shy, friendly, busy, withdrawn, emotional,

Aggressive) ______

Does you or your child’s doctor have any concerns about your child’s speech or physical development?

Have your child ever had any serious injuries or surgeries? Explain

Describe any health problems or concerns, such as asthma, allergies to food etc….

Is there any information that you would like us to know about your family’s culture, ethnicity, language or religion.

Does your child have any siblings, pets or respond to nicknames ?

Does your child have an IEP ? If yes, we need to have a copy of the IEP


Signature of Parent of Guardian______Date ______

Past Your Bedtime is an equal opportunity employer and will not discriminate in employment or educational programs or activities, based on race, color, religion, age, national origin, ancestry, physical handicapped, sex ,sexual orientation, or union membership. Any and all accommodations

will be made for any person with disabilities.

Child and Adult Care Food Program

ChildCareCenter Meal Benefit Income Eligibility Form

Part 1. All Household Members
Names of Enrolled Child(ren)
(First, Middle Initial, Last) / Check if a foster child (the legal responsibility of a welfare agency or court)
* If all children Listed below are foster children, skip to Part 5 to sign this form. / Check
if NO income
Names of all Household Members(First, Middle Initial, Last)
Part 2. Benefits: If any member of your household received [State SNAP], [FDPIR], or [State TANF cash assistance], provide the name and case number for the person who receives benefits. If no one receives these benefits, skip to part 3.
name:______Case number: ______- ______
Part 3. If any child you are applying for is homeless, migrant, or a runaway, check the appropriate box and call [Your center director, Homeless Liaison, Migrant Coordinator at Phone #] Homeless  Migrant  Runaway
Part 4. Total Household Gross Income—You must tell us how much and how often
  1. Name (List only household members with income)
/ B. Gross income and how often it was received
1. Earnings from work before deductions / 2. Welfare, child support, alimony / 3. Pensions, retirement, Social Security, SSI, VA benefits / 4. All Other Income
Jane Smith / $200/weekly_____ / $150/twice a month_ / $100/monthly_____ / $______/______
$______/______/ $______/______/ $______/______/ $______/______
$______/______/ $______/______/ $______/______/ $______/______
$______/______/ $______/______/ $______/______/ $______/______
$______/______/ $______/______/ $______/______/ $______/______
$______/______/ $______/______/ $______/______/ $______/______
Part 5. Signature and Last Four Digits of Social Security Number (Adult must sign)
An adult household member must sign this form. If Part 3 is completed, the adult signing the form must also list the last four digits of his or her Social Security Number or mark the “I do not have a Social Security Number” box. (See Privacy Act Statement on the back of this page.)
I certify that all information on this form is true and that all income is reported. I understand that the center or day care home will get Federal funds based on the information I give. I understand that CACFP officials may verify the information. I understand that if I purposely give false information, the participant receiving meals may lose the meal benefits, and I may be prosecuted.
Sign Here: ______Print Name: ______Date: ______
Address: ______City:______State: ______Zip Code: ______
Phone Number: ______
Last four digits of Social Security Number: _* _* _* - _* _* - ______ I do not have a Social Security Number
Part 6. Participant’s ethnic and racial identities (optional)
Mark one ethnic identity: / Mark one or more racial identities:
 Hispanic or Latino
 Not Hispanic or Latino / Asian  American Indian or Alaska Native
White  Native Hawaiian or Other Pacific Islander
Black or African American
Don’t fill out this part. This is for official use only.
Annual Income Conversion: Weekly x 52, Every 2 Weeks x 26, Twice A Month x 24, Monthly x 12
Total Income: ______Per:  Week,  Every 2 Weeks,  Twice A Month, Month,  Year Household size: ______
Categorical Eligibility: _____ Eligibility: Free_____ Reduced_____ Denied (Paid)_____ Date Withdrawn: ______
Reason for Denied: ______
Temporary: Free_____ Reduced_____ Time Period: ______(expires after _____ days)
Determining Official’s Signature: ______Date: ______
Confirming Official’s Signature: ______Date: ______
Follow-up Official’s Signature: ______Date:______
Household size / Yearly
1 / $20,665
2 / $27,991
3 / $35,317
4 / $42,643
5 / $49,969
6 / $57,295
7 / $64,621
8 / $71,947
Each additional person: / +$7,326

The participant in the day care facility may qualify for free or reduced price meals if your household income falls within the limits on this chart.

Privacy Act Statement: The Richard B. Russell National School Lunch Act requires the information on this application. You do not have to give the information, but if you do not, we cannot approve the participant for free or reduced price meals. You must include the last four digits of the Social Security Number of the adult household member who signs the application. The Social Security Number is not required when you apply on behalf of a foster child or you list a Supplemental Nutrition Assistance Program (SNAP), Temporary Assistance for Needy Families (TANF) Program or Food Distribution Program on Indian Reservations (FDPIR) case number for the participant or other (FDPIR) identifier or when you indicate that the adult household member signing the application does not have a Social Security Number. We will use your information to determine if the participant is eligible for free or reduced price meals, and for administration and enforcement of the Program.
Non-discrimination Statement: This explains what to do if you believe you have been treated unfairly. “In accordance with Federal Law and U.S. Department of Agriculture policy, this institution is prohibited from discriminating on the basis of race, color, national origin, sex, age, or disability. To file a complaint of discrimination, write USDA, Director, Office of Adjudication, 1400 Independence Avenue, SW, Washington, D.C.20250-9410 or call toll free (866) 632-9992 (Voice). Individuals who are hearing impaired or have speech disabilities may contact USDA through the Federal Relay Service at (800) 877-8339; or (800) 845-6136 (Spanish). USDA is an equal opportunity provider and employer.”

Past Your Bedtime Childcare Center

Parent Handbook


Hello, Welcome to “Past Your Bedtime”. This center is a comprehensive, learning and full day care program. Our goal is to provide children with activities to help them grow mentally, socially, emotionally and physically. We serve families with children from Infants to school aged children.

Hours of Operation

Past Your Bedtime is open daily Mon- Friday from 7:00 am until 9:00pm


Past Your Bedtime will provide breakfast, lunch and snack,

Menus will be posted weekly. Breakfast is scheduled between 7:30 and 9:30. Children should be at school no later than 9:30 to eat breakfast. Breakfast will not be served after 9:30am.

Arrival / Departure

All children must arrive by 10:00 am each day. Parents who know that they will be arriving after 10:00am should contact the center to let us know that your child will be late. Staff will then notify the classroom teacher of the late arrival.

7:30 am. – 9:30 am. Breakfast

12:00am-12:30pm Lunch

3: 15pm- 3:30pm Snack

Parents must escort children into the center, remove all coats and book bags and hang them inside the cubbies. Older toddlers and Preschoolers should be encouraged to hang up their own belongings.

Curriculum- Past Your Bedtime Childcare Center uses the Creative Curriculum with all of the children at our center. The Creative Curriculum is an evidence based tool used to ensure that young children are receiving an education that is challenging and engaging, developmentally appropriate, culturally and linguistically responsive, include critical developmental learning stations, with positive short term and long term outcomes for the children.

Our preschool children are also using the Second Step curriculum which helps in developing self regulation, your child will develop skills that will help them to pay attention, remember directions and control behavior in the classroom.

Program Philosophy- Our philosophy states that children thrive in a safe, nurturing and friendly environment that employs staff who has dedicated their careers to working with children. Our center uses developmentally appropriate practices that will help nurture and challenge the absorbing mind of the young child.

Children’s Goals- The children at our center are assessed using a developmental screening called Ages and Stages, immediately within the first 45 days of care at our center. Once we have completed the assessment a Getting to Know You meeting will be set up to go over the results of the assessment. During this time we will discuss with you the short term and long term goals for your child and also use any feedback that the parent may have regarding your child’s development. Once goals are established we incorporate these goals into our weekly lesson plans for your child.

Our children are also assessed by using an effective tool called Teaching Strategies Gold; this assessment follows the Common Core Standards, state early learning guidelines and the Head Start Child development and Early Learning Framework. This tool assures that, infants, toddlers, and preschool children are working to the best of their abilities and that the center is providing the highest level of care that will assist your child in succeeding.

Once your child is assessed using this tool a conference will be offered to discuss the results of the assessment and to also discuss any areas of concern. Conferences are offered so that the classroom teacher and the parent can discuss similarities and differences that may occur in and out of the classroom. Parents may offer a lot of information that is valuable in properly assessing young children.

Enrollment- Our enrollment consist of Infants through preschool aged children. Our families come from racially diverse backgrounds with a mixed group of income levels.

Content- The key learning areas of development include Math, Art, Social Studies, Writing, Reading, and Science. All key areas are taught using developmentally appropriate practices.

Diaper Requirements

Parents are responsible for providing disposable diapers and wipes for their children. Your child’s diapers will only be used by your child. Children will not be permitted without their diapers or pull ups. We will not provide them. Please label all diapers and wipes.

A diaper fee of $1.00 will be added if we have to provide diapers for your child.

Children’s Needs

Infants- Crib sheet, labeled bottles, diapers, wipes, complete change of clothes (socks, undershirt, shirt, pants) , formula and an optional ( personal comfort toy )

Toddlers- blanket for naptime, labeled cup, diapers, wipes, complete change of clothes (socks, undershirt, shirt, pants)

Preschool- blanket for naptime, pull ups (optional), complete change of clothes (socks, undershirt, shirt, pants)

Sick Children

Please do not bring your child to school if he/ she is sick, this is very uncomfortable for the child and very unhealthy for this center, if you child has symptoms of a contagious illness please keep them home, if your child gets sick in school you will be notified to pick them up early.

Upon arrival if staff notices that your child is exhibiting any of the following symptoms he/she will have to be excluded until a doctor can clear the illness.

Examples of exclusion illnesses are ( virus, pinkeye, strep throat, fever, chicken pox, measles, ring worm, diarrhea which is leaking through the diaper, Whooping cough etc. ).

Your child will be excluded if they show two or more of the following symptoms:

Diarrhea (leaking through diaper)



Your child will be excluded from the center until he/she is symptom free for a min of 24 hours and/or a note from a physician.

Illness and Injury Procedures

All illnesses and injuries will be tracked as they occur and monitored monthly. Any corrective procedures or action plans will be taken as soon as possible.

A complete breakdown of this policy is available by contacting the program director.


Staff may administer prescription/non prescription medication only if written directions are provided with the medication and with a doctor’s label. Parent must also sign the medication log with directions for administration. A med certified staff person will administer the medication to your child.

Release of Children

A child shall be released only to the child’s parent or to another designated person. A parent may call the center and give an oral designation, but that person must have identification. Children will be released to both parents unless there is a court ordered document that is on file with PYBT.

Transition of Records

All files are confidential and will only be released with parents written consent. If your child is transitioning to another educational facility, and you would like us to forward your child's records you must do so in writing. Please contact the center director for a request for records form. If your child has an IEP or IFSP, please provide this center with a copy of the plan.

Open Door Policy

A parent of a child that is enrolled in our program is due the right of access throughout the center during normal business hours, without prior notices whenever their child is in care. This same privilege will not apply if there is a court order denying the parent access to the child.

Discipline Philosophy:

Children at this facility are expected to follow general rules while attending our center, but we all know that there are times that children may not be at their best with following directions. Our discipline policy states that we will not use time out or any physical, verbal abuse, or food restrictions while your child is in our care. Instead, your child will be redirected to participate in another activity or simply given time until he/she is ready to rejoin the group.

Child Abuse Policy

The staff at Past Your Bedtime are mandated reporters for the state of Pennsylvania if any staff member suspects that a child has been abused we are required by law to report the suspected abuse to the Dept of Human Services. We will contact Childline at 1-800-932-0313

Termination and Withdrawal Policy

The administration and staff love working with children but there are times where the love of children is simply not enough. There may be times when we have exhausted all alternatives and the only logical solution is to terminate our services.

The following are some reasons that our services may be terminated:

Gross Behavior problems including but not limited to (excessive fighting, biting, and any gross physical contact with a child or a teacher with the intent of malice.

Destruction of school property.

All gross behaviors problems will be documented and a copy given to the parent. After 3 letters the child will be dismissed from the program.

Parents failure to follow center rules including, but not limited to, completion of forms, disrespect to staff, fighting, theft and non- payment of tuition, late fees and co-pays.

Please notify us within two weeks of withdrawal from the program.


Tuition is due on Monday Morning. If you do not have payment on Monday morning, your child will not be allowed to stay in the program. Tuition may be paid weekly only . Full weeks pay is due if your child stays three days or more out of the week There will be no refunds if your child does not stay for the whole week .

Late Fee Policy

If your child stays over the agreed time for pickup, the parent will be assessed a fee of $1.00 per minute. This fee must be paid before your child can come back to the program.


Past Your Bedtime will be observing the following holidays:

Martin Luther King Day

President’s Day

Memorial Day

Independence Day

Labor Day

Veterans Day

Thanksgiving Day and the day after Thanksgiving Day Nov 25th and Nov. 26th

Dec. 24th and Dec. 31

Good Friday

Staff summer vacation is always the last week in August for the whole week

Staff Holidays are subject to modification.

Snow Closing Policy

If the Phila Public School System closes early due to inclement weather we will be closing ½ hour later. If you are unsure about a school closing, call the center and listen for a message from the director. Our KYW school number is 3102, you can also watch NBC 10 to see if we are closed. I will also leave a message on the answering machine. Our website will also have school closing information you can reach our website @