WORKFORCE SOLUTIONS FOR THE HEART OF TEXAS

PARENT ENROLLMENT AGREEMENT

Parent Name: SS#: / Telephone Number:
Address, City, State, Zip
Name of Child / Date of Birth / Name of Child / Date of Birth
1. / 5.
2. / 6.
.
3.
. / 7.
4.
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I understand that I may request an administrative review with CPS worker’s Supervisor If child care services are denied, reduced, or terminated. The CPS worker will inform me of the procedures for requesting such a review.
I have read the agreement and understand my responsibilities regarding child care and have been given a copy of the form.
I understand that I am responsible, not EOAC or the Board, for the quality of the child care services my child may receive from the facility of my choosing.

Dear Parent:

The purpose of this agreement is to ensure that you understand your responsibilities regarding the child care authorized for CPS children. Another purpose is to inform you of the conditions upon which child care and payment are based. You will be required to agree to all items listed below. You must also agree to additional requirements specified by the child care facility in which a CPS child is enrolled.

  1. ENROLLMENT REQUIREMENTS
  1. I must be in school, training, or employed to be eligible. I understand that only EOAC can authorize a child care arrangement for my child, including changes in the provider of care.
  2. In advance or within 10 calendar days after the change occurs, I will inform EOAC and the child care facility about changes (either temporary or permanent) in my:

-Work, school, or training,

-Income,

-Loss of TANF or Supplemental Security Income assistance grants, or

-Any other changes that might affect eligibility for services.

  1. In advance or as soon as possible after the change occurs, I will inform EOAC and the child care facility about changes in my:

-residence,

-telephone number,

-emergency contact information, or

-child care arrangements

  1. I will comply with all Texas Workforce Commission, Workforce Solutions Heart of Texas Local Workforce Development Board, EOAC, and provider requirements or have child care services denied or terminated.
  2. If I do not notify EOAC that I no longer work or attend school or training, I will be responsible for paying all child care payments made while I was ineligible.
  3. If I am given a For 2449, I must pay the monthly fee amount as specified to remain eligible.\
  1. CHILD CARE FACILITY REQUIREMENTS
  1. I will meet the enrollment requirements and all other policies specified by the child care facility in which my child is enrolled.
  2. I will provide information, including health and immunization records authorization to secure medical assistance, and parent contact information to be used in case of an emergency.
  3. I will be on time and honor the child care facility's starting and closing hours. I will pay any overtime charges incurred if I am late picking up my child from the facility.
  4. I will report to the Texas Department of Family and Protective Services licensing office any complaints about a possible violation of licensing standards which affects the care of children in the facility.
  5. I will make other child care arrangements when I am no longer eligible for Board child care services.
  6. If I need child care on any of the vendor's nine paid holidays, I will make and pay for my own arrangements.
  1. TRANSPORTATION REQUIREMENTS (apply only if transportation is provided)
  1. I will stay with my child or make sure someone else does until the bus arrives each morning.
  2. I will be at home or make sure someone else is at home when my child arrives home in the evening.
  3. Any day my child will be absent from the child care facility, I will call the facility early enough to keep the bus from coming to my home.
  1. REQUIREMENT FOR NOTIFICATION OF ABSENCE
  1. I will notify the child care facility when my child is going to be absent and tell them the reason for the absence.
  2. I understand that there is a limit on the number of absences my child may have in a 12 month period.
  3. I understand that my child's care will end if my child is absent for 30 days or more in the 12 month period.
  4. I understand that my child's care will end if my child is absent for 5 or more consecutive days and I have not called the child care facility or EOAC to explain the reason for the absence.

RIGHTS AND RESPONSIBILITIES OF PARENTS OR CARETAKERS

  1. To have persons represent them when applying for child care services.
  2. To be notified about their eligibility for services within 20 calendar days from the date all application documents are received by EOAC.
  3. To visit available child care facilities before making their choice of a child care provider, visit during child care services, and to participate in activities in which their child is enrolled.
  4. To receive assistance in choosing initial or additional child care referrals including information about the Board’s policies regarding transferring children from one provider to another.
  5. To appeal denial, reduction, or termination of services. This does not apply to parents who have children in in-home CPS cases and did not request child care. The procedure for requesting air hearings will be provided by EOAC.
  6. To have the Board and EOAC treat as confidential information that is used to determine eligibility for services.
  7. To receive services without regard to race, sex, color, national origin, age, political beliefs, religion, or disability.
  8. To reject an offer of child care services or voluntarily withdraw their child from child care services.
  9. To be notified in writing by EOAC at least 15 calendar days before the denial, delay, reduction, or termination of services, except in cases where the Choices or CPS works has authorized child care to end immediately.
  10. To provide EOAC with all information necessary to establish eligibility to receive child care services. This information must be provided within 13 calendar days from the day EOAC sent the request.
  11. To report changes in income or family size, loss of TANF or Supplemental Security Income assistance grants.
  12. To understand that failure to report changes may result in termination of services, recovery of payments by the Board, EOAC or the Commission and investigation for suspected fraud.

______

Signature-Person Requesting Services DateSignature-EOAC Representative Date

PARENT AGREEMENT FOR USE OF THE

CHILD CARE AUTOMATED ATTENDANCE CARD

Parent/Caretaker: ______

(print name)

As a requirement for receiving child care services, I agree to the following:

  • I understand that use of the Child Care Attendance Automation card (attendance card) is mandatory.
  • I must use the attendance card to report attendance and absences.
  • If I do not report attendance or absences using the attendance card:

my child care services may be terminated; and

I may be responsible for paying my provider.

  • Each day that I do not report attendance/absence using the attendance card, it will be counted as an absence
  • If I do not use the attendance card for 5 days in a row that will be considered 5 days no contact, and my childcare will be terminated.
  • If I am terminated for thirty (48) absences or 5 days no contact, due to failure to use my attendance card, I cannot apply for CCS again for 30 days.
  • I will be notified when my child/ren reaches 50 percent and 75 percent of the allowed absences.
  • I understand that the provider cannot collect double reimbursement for unreported attendance.
  • If I misplace my attendance card, I can receive one replacement card free of charge. I will be charged a $10.00 fee for the second replacement card and a $15.00 fee for the third replacement card.
  • I can designate up to three individuals as secondary cardholders to report attendance and absences on my behalf;
  • The secondary cardholder must be at least 18 years old, unless the individual is the child’s parent.
  • I must not designate the owner or director of the child care facility as a secondary cardholder.
  • I am responsible for any misuse of the attendance card by any secondary cardholder.
  • I am responsible for watching the client training video.
  • I am responsible for checking the message on the POS machine after each swipe to see if it is approved, denied, or pending. If the message shows denied or pending, I am responsible to report the problem to my caseworker immediately.
  • I am responsible for informing any secondary cardholders of these requirements and their responsibility for using the attendance card.

I also understand that my child care services can be terminated if I or the secondary cardholder:

  • gives the attendance card to someone else—including the child care provider; or
  • gives the personal identification number to someone else.

I acknowledge that I have read and agreed to this parent agreement, and all of my questions about this agreement have been answered:

Parent Signature: ______Date:______

The Texas Workforce Commission prosecutes fraud to ensure that child care funds are maximized for qualified families. To report suspected fraud, call the fraud hot line at (800) 252-3642.

Workforce Solutions for the Heart of Texas - Child Care Services

1416 S. New Road, 2nd Floor ▪ Waco, Texas 76711 ▪ (254) 296-5374 ▪ FAX (254) 753-6355

The Heart of Texas Workforce Board, Inc. is an equal opportunity employer/programs and auxiliary aids and services are available upon request to include individuals with disabilities. TTY/TDD via RELAY Texas service at 711 or (TDD) 1-800-735-2989 / 1-800-735-2988 (voice).