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New Jersey Department of Children and Families Policy Manual

 

Manual:

CP&P

Child Protection & Permanency

Effective Date:

Volume:

X

Forms

Chapter:

A

Forms

 

7-29-2016

Subchapter:

1

Forms

Issuance:

CC.194

CC-194, Authorization for CPS Child Care

 

 

Click here to view, complete, or print the DFD form CC-194, Authorization for CPS Child Care.

 

WHEN TO USE IT  

 

Use the DFD form CC-194 to request authorization for child care services from the Child Care Resource and Referral agency.  Attach the CP&P Form 16-76, Special Approval Request.

 

HOW TO USE IT

 

The Child Care Liaison completes the form.  The LO’s Child Care Liaison approves the child care placement by signing the form and submitting it to the Child Care Resource and Referral agency within five business days of the need for child care or the need for a new child care placement being identified.

 

TIPS FOR COMPLETING THE FORM

 

The child’s Social Security number is required.  If the Worker does not know it at the time the form CC-194 is completed, the Worker must get the Social Security number and forward through the Child Care Liaison it to the CCR&R within 90 days.

 

If the child is not a U.S. citizen, the Worker must determine whether the child is a qualified alien or not.  Use the attached Documentation to Determine Qualified Alien Status chart which lists all types of documentation which verify qualified alien status. 

 

This information is not required to determine eligibility for child care.  The Division of Family Development uses it to determine the correct funding source for child care.

 

DISTRIBUTION

 

Original

-

Child Care Resource and Referral agency

 

Copy

-

Child’s case record