background shadows

 

 

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.196

CC-196, Notice of Change in CPS Child Care Status

 

 

Click here to view, complete, or print the DHS form CC-196, Notice of Change in CPS Child Care Status.

 

WHEN TO USE IT

 

The purpose of this form is to notify the Child Care Resource and Referral (CCR&R) agency of:

 

  • An extension of child care,
  • Termination of child care, or
  • A change in the child care provider.

 

HOW TO USE IT

 

The Worker completes and signs the CC-196 and forwards it to the Child Care Liaison. 

 

The Child Care Liaison reviews and approves the action noted on the form and forwards it to the CCR&R within five business days of the noted change.

 

DISTRIBUTION

 

Original                      -                       Child Care Resource and Referral agency

 

Copy                           -                       Child’s case record